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General NPI Number Information
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NPI Number | 1306125901
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Entity Type | Organization
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Legal Business Name | GREGORY J VALENTINE A C P C
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Dates
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Enumeration Date | 08/12/2011
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Last Update Date | 09/08/2011
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Provider Practice Location Address
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Address Line | 162 N RAYMOND AVE
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City | FULLERTON
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State | CA
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Zip | 92831-4610
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Country | US
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Telephone | 714-738-0115
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Fax | 714-525-0755
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Provider Business Mailing Address
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Address Line | 15550 ROCKFIELD BLVD B220
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City | IRVINE
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State | CA
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Zip | 92618-2720
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Country | US
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Telephone | 949-598-9999
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Fax | 949-598-9990
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Authorized Official
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Title or Position | PROVIDER
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Name | GREGORY J VALENTINE
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Credential | D.C.
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Telephone | 714-738-0115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC16571
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License Number State | CA
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