Basic Information
| Provider Information | |||||||||
| NPI: | 1033132469 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROBERTO N VALENTON MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 556 S FAIR OAKS AVE | ||||||||
| Address2: | SUITE 101, PMB #232 | ||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911052656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6263546091 | ||||||||
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| Practice Location | |||||||||
| Address1: | 301 VICTORIA ST | ||||||||
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| City: | COSTA MESA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926271995 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9496422734 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 07/19/2010 | ||||||||
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| AuthorizedOfficialLastName: | VALENTON | ||||||||
| AuthorizedOfficialFirstName: | ROBERTO | ||||||||
| AuthorizedOfficialMiddleName: | NATIVIDAD | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6263546091 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | A34485 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.