Provider Demographics
NPI:1598701062
Name:VALLEY INTEGRATED HEALTH CARE SERVICE
Entity Type:Organization
Organization Name:VALLEY INTEGRATED HEALTH CARE SERVICE
Other - Org Name:BALBOA SLEEP DISORDER LABORATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SACRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANG
Authorized Official - Middle Name:HEE
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-701-8771
Mailing Address - Street 1:9900 BALBOA BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-5403
Mailing Address - Country:US
Mailing Address - Phone:818-701-8771
Mailing Address - Fax:818-701-0073
Practice Address - Street 1:9900 BALBOA BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-5403
Practice Address - Country:US
Practice Address - Phone:818-701-8771
Practice Address - Fax:818-701-0073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty