MEDICARE: HAROLD CARDINALVALERY M.D. INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033393962
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAROLD CARDINALVALERY M.D. INC.

Provider Business Mailing Address
First Line	:	1655 S WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-5801
Country	:	US
Telephone Number	:	323-737-5200
Fax Number	:	323-737-5400

Provider Business Practice Location Address
First Line	:	1655 S WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-5801
Country	:	US
Telephone Number	:	323-737-5200
Fax Number	:	323-737-5400

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HAROLD CARDINAL VALERY
Credential	:	M.D.
Telephone Number	:	323-737-5200

Provider Enumeration Date	:	12/27/2007
Last Update Date	:	12/27/2007

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