Healthcare Provider Details

I. General information

NPI: 1003149303
Provider Name (Legal Business Name): WEST VALLEY HOSPITALIST ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2009
Last Update Date: 09/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6520 PLATT AVE #396
WEST HILLS CA
91307-3218
US

IV. Provider business mailing address

6520 PLATT AVE #396
WEST HILLS CA
91307-3218
US

V. Phone/Fax

Practice location:
  • Phone: 818-307-3387
  • Fax: 818-992-0046
Mailing address:
  • Phone: 818-307-3387
  • Fax: 818-992-0046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA67128
License Number StateCA

VIII. Authorized Official

Name: DR. JEREMY IAN GROSSER
Title or Position: PRESIDENT
Credential: MD
Phone: 818-307-3387