Provider Demographics
NPI:1609469998
Name:HEALTH VALLEY PROVIDER NETWORK INC
Entity Type:Organization
Organization Name:HEALTH VALLEY PROVIDER NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRIJESH
Authorized Official - Middle Name:
Authorized Official - Last Name:BHAMBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-371-2784
Mailing Address - Street 1:5080 CALIFORNIA AVENUE
Mailing Address - Street 2:SUITE 415
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1994
Mailing Address - Country:US
Mailing Address - Phone:661-371-2784
Mailing Address - Fax:661-491-7004
Practice Address - Street 1:5080 CALIFORNIA AVENUE
Practice Address - Street 2:SUITE 415
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1994
Practice Address - Country:US
Practice Address - Phone:661-371-2784
Practice Address - Fax:661-491-7004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization