Healthcare Provider Details
I. General information
NPI: 1225820277
Provider Name (Legal Business Name): TRIVALLEY VASECTOMY INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/17/2025
Last Update Date: 05/17/2025
Certification Date: 05/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1985 FIRST ST STE 205
LIVERMORE CA
94550-4485
US
IV. Provider business mailing address
1985 FIRST ST STE 205
LIVERMORE CA
94550-4485
US
V. Phone/Fax
- Phone: 925-701-1090
- Fax:
- Phone: 925-701-1090
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELYAS
PARSA
Title or Position: OWNER
Credential:
Phone: 925-701-1090