Healthcare Provider Details

I. General information

NPI: 1043423460
Provider Name (Legal Business Name): VALLEY PEDIATRICS MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14901 RINALDI ST SUITE 330
MISSION HILLS CA
91345-1204
US

IV. Provider business mailing address

14901 RINALDI ST SUITE 330
MISSION HILLS CA
91345-1204
US

V. Phone/Fax

Practice location:
  • Phone: 818-365-7778
  • Fax: 818-365-7808
Mailing address:
  • Phone: 818-365-7778
  • Fax: 818-365-7808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MANISHA SANGHVI
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 818-365-7778