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NPI Code Detail

MEDICARE: VALENCIA SPORTS MEDICINE AND REHAB

MEDICARE: VALENCIA SPORTS MEDICINE AND REHAB
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
1111N00000XChiropractorDC28344CA
2208100000XPhysical Medicine & Rehabilitation PhysicianG74794CA

General Provider Information

NPI Number : 1972897965
Entity Type Code : Organization
Provider Name (Legal Business Name) : VALENCIA SPORTS MEDICINE AND REHAB
Provider Business Mailing Address
First Line : 24517 TOWN CENTER DR
Second Line :
City : VALENCIA
State : CA
Zip : 91355-1328
Country : US
Telephone Number : 661-288-1212
Fax Number : 661-288-1715
Provider Business Practice Location Address
First Line : 24517 TOWN CENTER DR
Second Line :
City : VALENCIA
State : CA
Zip : 91355-1328
Country : US
Telephone Number : 661-288-1212
Fax Number : 661-288-1715
Authorized Official
Title or Position : CHIROPRACTOR
Name : DR. JEFF DAVID BOWNE
Credential : D.C
Telephone Number : 661-288-2224
Provider Enumeration Date : 06/07/2011
Last Update Date : 06/17/2011

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Directions to “VALENCIA SPORTS MEDICINE AND REHAB ” Practice Location

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