Provider Demographics
NPI:1558663245
Name:VALLEY CARE SELECT IPA
Entity Type:Organization
Organization Name:VALLEY CARE SELECT IPA
Other - Org Name:VALLEY CARE SELECT IPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-918-5359
Mailing Address - Street 1:751 E DAILY DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6076
Mailing Address - Country:US
Mailing Address - Phone:805-604-3332
Mailing Address - Fax:
Practice Address - Street 1:751 E DAILY DR
Practice Address - Street 2:SUITE 120
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6076
Practice Address - Country:US
Practice Address - Phone:805-604-3332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY CARE PHYSICIANS IPA MEDICAL ASSOCIATES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-01
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization