Healthcare Provider Details

I. General information

NPI: 1366397127
Provider Name (Legal Business Name): CIRCLE CITY CRNA ANESTHESIA P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35467 MEADOW PARK CIR
WILDOMAR CA
92595-7730
US

IV. Provider business mailing address

35467 MEADOW PARK CIR
WILDOMAR CA
92595-7730
US

V. Phone/Fax

Practice location:
  • Phone: 951-543-6565
  • Fax:
Mailing address:
  • Phone: 951-543-6565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: SCOTT DANIEL VALENZUELA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: CRNA
Phone: 951-543-6565