Provider Demographics
NPI:1497760151
Name:VALENTON, EVELYN YANIT (MD)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:YANIT
Last Name:VALENTON
Suffix:
Gender:F
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 60790
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91116-6790
Mailing Address - Country:US
Mailing Address - Phone:626-795-6596
Mailing Address - Fax:626-795-8247
Practice Address - Street 1:1701 SANTA ANITA AVE
Practice Address - Street 2:
Practice Address - City:SOUTH EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-3411
Practice Address - Country:US
Practice Address - Phone:626-579-7777
Practice Address - Fax:626-350-7986
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35349207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A353490OtherBLUE SHIELD
CA00A353490Medicaid
CAWA35349AMedicare PIN
CA00A353490Medicaid
CA00A353490Medicaid