Healthcare Provider Details

I. General information

NPI: 1477803724
Provider Name (Legal Business Name): VALENCIA SPECIALTY SURGERY CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2012
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25802 HEMINGWAY AVE STE 102
STEVENSON RANCH CA
91381-2392
US

IV. Provider business mailing address

PO BOX 16297
BEVERLY HILLS CA
90209-2297
US

V. Phone/Fax

Practice location:
  • Phone: 800-991-6448
  • Fax: 424-369-9555
Mailing address:
  • Phone: 800-991-6448
  • Fax: 424-369-9555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number3493924
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier3493924
Identifier TypeOTHER
Identifier StateCA
Identifier IssuerCORPORATIONID

VIII. Authorized Official

Name: MRS. DANIEL P TAHERI
Title or Position: CEO
Credential:
Phone: 661-388-5240