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General NPI Number Information
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NPI Number | 1730263484
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Entity Type | Individual
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Provider Name | GUILLERMO J VALENZUELA MD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 05/29/2020
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Provider Practice Location Address
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Address Line | 400 N PEPPER AVE MOB 206
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City | COLTON
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State | CA
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Zip | 92324-1801
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Country | US
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Telephone | 909-580-6333
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Fax | 909-580-3289
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Provider Business Mailing Address
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Address Line | PO BOX 1762
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City | COLTON
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State | CA
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Zip | 92324-0857
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Country | US
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Telephone | 909-580-6332
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Fax | 909-580-3289
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | A38671
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License Number State | CA
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