Healthcare Provider Details

I. General information

NPI: 1982800678
Provider Name (Legal Business Name): PAYAM VALI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 S PALISADE DR
SANTA MARIA CA
93454-5948
US

IV. Provider business mailing address

235 S PALISADE DR
SANTA MARIA CA
93454-5948
US

V. Phone/Fax

Practice location:
  • Phone: 805-739-3561
  • Fax: 805-739-3560
Mailing address:
  • Phone: 805-739-3561
  • Fax: 805-739-3560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberA107176
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: