Healthcare Provider Details

I. General information

NPI: 1497686232
Provider Name (Legal Business Name): VALLEY WELLNESS CLINIC. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16260 VENTURA BLVD STE 420
ENCINO CA
91436-2241
US

IV. Provider business mailing address

16260 VENTURA BLVD STE 420
ENCINO CA
91436-2241
US

V. Phone/Fax

Practice location:
  • Phone: 818-940-0922
  • Fax: 818-940-0933
Mailing address:
  • Phone: 818-940-0922
  • Fax: 818-940-0933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MITCHELL BRANDON STOTLAND
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 818-940-0922