Provider Demographics
NPI:1710344197
Name:VALLEY GASTROENTEROLOGY CONSULTANTS
Entity Type:Organization
Organization Name:VALLEY GASTROENTEROLOGY CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:TARAKJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD273
Authorized Official - Phone:626-359-3330
Mailing Address - Street 1:488 E SANTA CLARA ST STE 103
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-7231
Mailing Address - Country:US
Mailing Address - Phone:626-359-3330
Mailing Address - Fax:626-359-3339
Practice Address - Street 1:488 E SANTA CLARA ST STE 103
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-7231
Practice Address - Country:US
Practice Address - Phone:626-359-3330
Practice Address - Fax:626-359-3339
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INSIGHT DIGESTIVE HEALTH CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFV0655110261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center