Healthcare Provider Details

I. General information

NPI: 1477983989
Provider Name (Legal Business Name): VALLEY NEUROSURGICAL INSTITUTE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2013
Last Update Date: 05/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S BUENA VISTA ST
BURBANK CA
91505-4809
US

IV. Provider business mailing address

501 S BUENA VISTA ST
BURBANK CA
91505-4809
US

V. Phone/Fax

Practice location:
  • Phone: 818-847-4835
  • Fax: 818-847-4842
Mailing address:
  • Phone: 818-847-4835
  • Fax: 818-847-4842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOUNG H. LEE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 818-847-4835