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General NPI Number Information
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NPI Number | 1548539653
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Entity Type | Organization
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Legal Business Name | RAINILDA P. VALENCIA, M.D., INC.
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Dates
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Enumeration Date | 12/19/2011
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Last Update Date | 12/19/2011
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Provider Practice Location Address
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Address Line | 12677 HESPERIA RD SUITE 160
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City | VICTORVILLE
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State | CA
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Zip | 92395-7735
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Country | US
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Telephone | 760-955-5656
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Fax | 760-955-6176
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Provider Business Mailing Address
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Address Line | 12677 HESPERIA RD SUITE 160
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City | VICTORVILLE
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State | CA
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Zip | 92395-7735
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Country | US
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Telephone | 760-955-5656
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Fax | 760-955-6176
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MARYELLEN KIDWELL
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Credential |
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Telephone | 760-955-5656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A53787
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License Number State | CA
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