Provider Demographics
NPI:1548201965
Name:VALLEY OB/GYN MEDICAL GROUP,INC.
Entity Type:Organization
Organization Name:VALLEY OB/GYN MEDICAL GROUP,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIZVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-765-1766
Mailing Address - Street 1:1600 E FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-8639
Mailing Address - Country:US
Mailing Address - Phone:951-765-1766
Mailing Address - Fax:951-765-1770
Practice Address - Street 1:1600 E FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-8639
Practice Address - Country:US
Practice Address - Phone:951-765-1766
Practice Address - Fax:951-765-1770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0102090Medicaid
CAGR0102090Medicaid