Healthcare Provider Details

I. General information

NPI: 1306768957
Provider Name (Legal Business Name): VALENTINA PARK MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23700 CAMINO DEL SOL
TORRANCE CA
90505-5017
US

IV. Provider business mailing address

3126 PACIFIC COAST HWY # 48
TORRANCE CA
90505-6708
US

V. Phone/Fax

Practice location:
  • Phone: 424-248-8090
  • Fax:
Mailing address:
  • Phone: 424-246-8090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: VALENTINA PARK
Title or Position: CEO
Credential: MD
Phone: 424-248-8090