MEDICARE: RINA CHETAN VALIA

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	261QH0700X	Hearing and Speech Clinic/Center

General Provider Information

NPI Number	:	1497375653
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RINA CHETAN VALIA

Provider Business Mailing Address
First Line	:	2907 S EL CAMINO REAL
Second Line	:
City	:	SAN MATEO
State	:	CA
Zip	:	94403-2730
Country	:	US
Telephone Number	:	650-627-6114
Fax Number	:

Provider Business Practice Location Address
First Line	:	2907 S EL CAMINO REAL
Second Line	:
City	:	SAN MATEO
State	:	CA
Zip	:	94403-2730
Country	:	US
Telephone Number	:	650-627-6114
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RINA VALIA
Credential	:	HIS
Telephone Number	:	650-627-6114

Provider Enumeration Date	:	04/17/2020
Last Update Date	:	04/17/2020

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