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General NPI Number Information
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NPI Number | 1780984724
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Entity Type | Organization
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Legal Business Name | ARTHUR VICTOR C VALLES MD INC
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Dates
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Enumeration Date | 10/25/2010
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Last Update Date | 10/25/2010
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Provider Practice Location Address
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Address Line | 2209 N SAN FERNANDO RD
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City | LOS ANGELES
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State | CA
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Zip | 90065-1231
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Country | US
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Telephone | 562-301-5306
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 42
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City | LA HABRA
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State | CA
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Zip | 90633-0042
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Country | US
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Telephone | 562-301-5306
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Fax |
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | MERCEDES JOHNSON
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Credential |
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Telephone | 562-301-5306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | A40329
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License Number State | CA
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