Provider Demographics
NPI:1194835652
Name:VALLEY EMERGENCY PHYSICIANS
Entity Type:Organization
Organization Name:VALLEY EMERGENCY PHYSICIANS
Other - Org Name:CORCORAN EMERGENCY MEDICAL GROUP INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-992-5057
Mailing Address - Street 1:1310 HANNA AVE
Mailing Address - Street 2:
Mailing Address - City:CORCORAN
Mailing Address - State:CA
Mailing Address - Zip Code:93212-2314
Mailing Address - Country:US
Mailing Address - Phone:559-992-5057
Mailing Address - Fax:559-992-4861
Practice Address - Street 1:1310 HANNA AVE
Practice Address - Street 2:
Practice Address - City:CORCORAN
Practice Address - State:CA
Practice Address - Zip Code:93212-2314
Practice Address - Country:US
Practice Address - Phone:559-992-5057
Practice Address - Fax:559-992-4861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0093540Medicaid
CAGR0093540Medicaid