Healthcare Provider Details

I. General information

NPI: 1245147214
Provider Name (Legal Business Name): VALLEY INTERVENTIONAL SPECIALTY CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16250 VENTURA BLVD STE 120
ENCINO CA
91436-2204
US

IV. Provider business mailing address

16250 VENTURA BLVD STE 160
ENCINO CA
91436-2270
US

V. Phone/Fax

Practice location:
  • Phone: 424-262-6260
  • Fax:
Mailing address:
  • Phone: 234-567-9026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NOURIEL NIAMEHR
Title or Position: CO-PRESIDENT AND DIRECTOR
Credential: DO
Phone: 424-262-6260