Healthcare Provider Details

I. General information

NPI: 1558472720
Provider Name (Legal Business Name): VALLE VERDE MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 01/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1332 NATIVIDAD RD STE C
SALINAS CA
93906-3133
US

IV. Provider business mailing address

1332 NATIVIDAD RD STE C
SALINAS CA
93906-3133
US

V. Phone/Fax

Practice location:
  • Phone: 831-754-1544
  • Fax: 831-754-2984
Mailing address:
  • Phone: 831-754-1544
  • Fax: 831-754-2984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG77264
License Number StateCA

VIII. Authorized Official

Name: DR. STEPHEN DOWER SAGLIO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: M.D.
Phone: 831-754-1544