Provider Demographics
NPI:1437262821
Name:VALENTINO, JOSEPH FAJARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FAJARDO
Last Name:VALENTINO
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 7007
Mailing Address - Street 2:HIGH DESERT MEDICAL GROUP
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93539-7007
Mailing Address - Country:US
Mailing Address - Phone:661-945-5984
Mailing Address - Fax:661-952-3667
Practice Address - Street 1:43839 15TH ST W
Practice Address - Street 2:HIGH DESERT MEDICAL GROUP
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4756
Practice Address - Country:US
Practice Address - Phone:661-945-5984
Practice Address - Fax:661-952-3667
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2021-11-22
Deactivation Date:2006-08-22
Deactivation Code:
Reactivation Date:2006-09-14
Provider Licenses
StateLicense IDTaxonomies
CAA74336207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A743360Medicaid
H66924Medicare UPIN
CA00A743360Medicaid