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General NPI Number Information
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NPI Number | 1558663245
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Entity Type | Organization
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Legal Business Name | VALLEY CARE SELECT IPA
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Dates
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Enumeration Date | 12/01/2010
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Last Update Date | 01/19/2017
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Provider Practice Location Address
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Address Line | 751 E DAILY DR SUITE 120
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City | CAMARILLO
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State | CA
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Zip | 93010-6076
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Country | US
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Telephone | 805-604-3332
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Fax |
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Provider Business Mailing Address
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Address Line | 751 E DAILY DR SUITE 120
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City | CAMARILLO
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State | CA
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Zip | 93010-6076
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Country | US
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Telephone | 805-604-3332
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | MELISSA CURTIS
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Credential |
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Telephone | 805-918-5359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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