Provider Demographics
NPI:1629207642
Name:VALLEY GASTROENTEROLOGY, INC.
Entity Type:Organization
Organization Name:VALLEY GASTROENTEROLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNAB
Authorized Official - Middle Name:
Authorized Official - Last Name:BISWAS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-991-5836
Mailing Address - Street 1:12565 HESPERIA RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-8318
Mailing Address - Country:US
Mailing Address - Phone:717-991-5836
Mailing Address - Fax:
Practice Address - Street 1:12565 HESPERIA RD
Practice Address - Street 2:SUITE 1
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-8318
Practice Address - Country:US
Practice Address - Phone:717-991-5836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-12
Last Update Date:2009-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty