Provider Demographics
NPI:1659796035
Name:VALLEY ACUTE CARE SURGEONS MEDICAL GROUP INC
Entity Type:Organization
Organization Name:VALLEY ACUTE CARE SURGEONS MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:HANPETER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-898-4900
Mailing Address - Street 1:11550 INDIAN HILLS RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-1200
Mailing Address - Country:US
Mailing Address - Phone:818-898-4900
Mailing Address - Fax:818-898-4990
Practice Address - Street 1:11550 INDIAN HILLS RD
Practice Address - Street 2:SUITE 310
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1200
Practice Address - Country:US
Practice Address - Phone:626-768-4415
Practice Address - Fax:626-403-0321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-21
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG838322086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Single Specialty