Healthcare Provider Details

I. General information

NPI: 1154478063
Provider Name (Legal Business Name): VALLEY ENDOCRINE & DIABETES CONSULTANS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S BUENA VISTA ST SUITE 225
BURBANK CA
91505-4569
US

IV. Provider business mailing address

201 S BUENA VISTA ST SUITE 225
BURBANK CA
91505-4569
US

V. Phone/Fax

Practice location:
  • Phone: 818-239-0288
  • Fax: 818-239-0889
Mailing address:
  • Phone: 818-239-0288
  • Fax: 818-239-0289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. MINH Q MACH
Title or Position: PRESIDENT
Credential: MD
Phone: 818-239-0288