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General NPI Number Information
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NPI Number | 1780779736
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Entity Type | Organization
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Legal Business Name | VALLEY ORTHOPEDIC ASSOCIATES MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 627 E FOOTHILL BLVD
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City | SAN DIMAS
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State | CA
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Zip | 91773-1208
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Country | US
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Telephone | 909-599-0881
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Fax | 909-394-0701
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Provider Business Mailing Address
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Address Line | 627 E FOOTHILL BLVD
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City | SAN DIMAS
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State | CA
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Zip | 91773-1208
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Country | US
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Telephone | 909-599-0881
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Fax | 909-394-0701
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. TONY SAMI BOUZ
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Credential | D.O.
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Telephone | 909-599-0881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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