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General NPI Number Information
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NPI Number | 1285386854
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Entity Type | Organization
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Legal Business Name | LUIS VALLEJO, M.D., INC.
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Dates
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Enumeration Date | 01/25/2022
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 125 S CRESCENT DR APT 6
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-3115
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Country | US
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Telephone | 281-655-7674
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Fax |
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Provider Business Mailing Address
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Address Line | 125 S CRESCENT DR APT 6
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-3115
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Country | US
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Telephone | 281-655-7674
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. LUIS JULIAN VALLEJO
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Credential | MD
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Telephone | 281-655-7674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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