MEDICARE: VALLEY VILLAGE HEALTH CLINIC PC

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1881330603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY VILLAGE HEALTH CLINIC PC

Provider Business Mailing Address
First Line	:	PO BOX 27206
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-0206
Country	:	US
Telephone Number	:	213-385-0675
Fax Number	:	213-365-6429

Provider Business Practice Location Address
First Line	:	12626 RIVERSIDE DR STE 301
Second Line	:
City	:	VALLEY VILLAGE
State	:	CA
Zip	:	91607-3473
Country	:	US
Telephone Number	:	818-452-9266
Fax Number	:	818-358-2079

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. JASON GROOMER
Credential	:	DO
Telephone Number	:	818-452-9266

Provider Enumeration Date	:	05/05/2022
Last Update Date	:	06/24/2025

Similar Medicare Providers

1225073588 — VALLEY ASSOCIATED UROLOGY MEDICARE GROUP INC
Practice Location Address:

200 COTTAGE AVE , STE 101
MANTECA, CA
95336-4935

Practice Phone: 209-239-2197
Practice Fax: 209-239-7672

1245518877 — MICHAL TAL PT
Practice Location Address:

12626 RIVERSIDE DR , STE 301
VALLEY VILLAGE, CA
91607-3473

Practice Phone: 818-760-0110
Practice Fax: 818-301-0137

1649676123 — DR. KIMIA FAGHIHI D.C.
Practice Location Address:

12626 RIVERSIDE DR STE 301
VALLEY VILLAGE, CA
91607-3473

Practice Phone: 818-452-9266
Practice Fax: 707-873-7835

1902455215 — LIANA MARINA GEVORKIAN
Practice Location Address:

12626 RIVERSIDE DR STE 301
VALLEY VILLAGE, CA
91607-3473

Practice Phone: 818-452-9266
Practice Fax:

1992308928 — MS. DANA ALTSCHULER LMT
Practice Location Address:

12626 RIVERSIDE DR STE 301
VALLEY VILLAGE, CA
91607-3473

Practice Phone: 818-642-1228
Practice Fax:

1144961814 — BERKSHIRE HOME HEALTH CARE INC
Practice Location Address:

12626 RIVERSIDE DR STE 301
VALLEY VILLAGE, CA
91607-3473

Practice Phone: 508-681-2778
Practice Fax:

Directions to “VALLEY VILLAGE HEALTH CLINIC PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.