Healthcare Provider Details

I. General information

NPI: 1285807867
Provider Name (Legal Business Name): VALLEY HEALTHCARE MED GRP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2008
Last Update Date: 04/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S BUENA VISTA ST 3RD FLOOR
BURBANK CA
91505-4569
US

IV. Provider business mailing address

201 S BUENA VISTA ST 3RD FLOOR
BURBANK CA
91505-4569
US

V. Phone/Fax

Practice location:
  • Phone: 818-842-7145
  • Fax:
Mailing address:
  • Phone: 818-842-7145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD J KROOP
Title or Position: PRESIDENT
Credential: MD
Phone: 818-842-7145