Healthcare Provider Details
I. General information
NPI: 1780431346
Provider Name (Legal Business Name): VALENTINES MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/02/2024
Last Update Date: 05/02/2024
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8990 GARFIELD ST STE 6
RIVERSIDE CA
92503-3922
US
IV. Provider business mailing address
8990 GARFIELD ST STE 6
RIVERSIDE CA
92503-3922
US
V. Phone/Fax
- Phone: 951-343-1616
- Fax: 951-343-1666
- Phone: 951-343-1616
- Fax: 951-343-1666
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VALENTINE
OTUECHERE
Title or Position: OWNER
Credential: MD
Phone: 951-343-1616