Provider Demographics
NPI:1265492987
Name:VALENTINE, LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:
Last Name:VALENTINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60041
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91066-6041
Mailing Address - Country:US
Mailing Address - Phone:626-447-0296
Mailing Address - Fax:626-447-6057
Practice Address - Street 1:508 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-1702
Practice Address - Country:US
Practice Address - Phone:724-832-4626
Practice Address - Fax:724-832-4668
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD017854E207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008811830019Medicaid
CAWG88116AMedicare PIN
PA0008811830019Medicaid
PA010730Medicare PIN
CAWG88116BMedicare PIN