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General NPI Number Information
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NPI Number | 1831470830
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Entity Type | Organization
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Legal Business Name | VALLEY CENTER FOR REPRODUCTIVE HEALTH INC
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Dates
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Enumeration Date | 09/02/2011
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Last Update Date | 03/24/2020
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Provider Practice Location Address
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Address Line | 4835 VAN NUYS BLVD STE 200B
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-2109
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Country | US
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Telephone | 818-986-1648
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Fax | 818-986-1653
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Provider Business Mailing Address
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Address Line | 4835 VAN NUYS BLVD STE 200B
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-2109
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Country | US
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Telephone | 818-986-1648
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Fax | 818-986-1653
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Authorized Official
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Title or Position | CEO
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Name | DR. TINA KOOPERSMITH
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Credential | M.D.
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Telephone | 818-986-1648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G69869
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License Number State | CA
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