Healthcare Provider Details

I. General information

NPI: 1932100070
Provider Name (Legal Business Name): VALENCIA PULMONARY MEDICAL GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23928 LYONS AVE SUITE 203
NEWHALL CA
91321
US

IV. Provider business mailing address

23928 LYONS AVE SUITE 203
NEWHALL CA
91321-2409
US

V. Phone/Fax

Practice location:
  • Phone: 661-254-7216
  • Fax: 661-254-4830
Mailing address:
  • Phone: 661-254-7216
  • Fax: 661-254-4830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHAND KHANNA
Title or Position: DOCTOR
Credential: M.D.
Phone: 661-254-7216