Provider Demographics
NPI:1598742769
Name:MARGETA, VALERIE (MD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:MARGETA
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 1:3400 LOMITA BLVD
Mailing Address - Street 2:STE 501
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4909
Mailing Address - Country:US
Mailing Address - Phone:310-257-0860
Mailing Address - Fax:310-257-0856
Practice Address - Street 1:3400 LOMITA BLVD
Practice Address - Street 2:STE 501
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4909
Practice Address - Country:US
Practice Address - Phone:310-257-0860
Practice Address - Fax:310-257-0856
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2015-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG55027207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E71895Medicare UPIN
G55027Medicare ID - Type Unspecified