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General NPI Number Information
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NPI Number | 1467632273
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Entity Type | Organization
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Legal Business Name | VALDERRAMA MD, INC
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 360 H STREET
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City | CHULA VISTA
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State | CA
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Zip | 91910
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Country | US
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Telephone | 619-397-5400
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Fax | 619-397-5445
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Provider Business Mailing Address
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Address Line | 360 H STREET
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City | CHULA VISTA
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State | CA
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Zip | 91910
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Country | US
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Telephone | 619-397-5400
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Fax | 619-397-5445
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Authorized Official
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Title or Position | CEO
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Name | DR. ARTURO H VALDERRAMA
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Credential | M.D.
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Telephone | 619-397-5400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A74152
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License Number State | CA
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