Healthcare Provider Details

I. General information

NPI: 1689508822
Provider Name (Legal Business Name): ALAN VALENTIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 DYNASTY DR
FAIRFIELD CA
94534-4159
US

IV. Provider business mailing address

545 DYNASTY DR
FAIRFIELD CA
94534-4159
US

V. Phone/Fax

Practice location:
  • Phone: 707-319-1206
  • Fax:
Mailing address:
  • Phone: 707-319-1206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number839167
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: