Provider Demographics
NPI:1245761683
Name:CLINIC OF THE VALLEY INC
Entity Type:Organization
Organization Name:CLINIC OF THE VALLEY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAYED
Authorized Official - Middle Name:
Authorized Official - Last Name:MONIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-351-8669
Mailing Address - Street 1:PO BOX 27518
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92809-0117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:195 W LEGION RD
Practice Address - Street 2:
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-7714
Practice Address - Country:US
Practice Address - Phone:760-351-8669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health