Provider Demographics
NPI:1922422930
Name:VALLEY CARDIOLOGY AND VASCULAR ASSOCIATES INC
Entity Type:Organization
Organization Name:VALLEY CARDIOLOGY AND VASCULAR ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BASIL
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:310-489-2022
Mailing Address - Street 1:4201 TORRANCE BLVD.
Mailing Address - Street 2:SUITE 420
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503
Mailing Address - Country:US
Mailing Address - Phone:310-540-1953
Mailing Address - Fax:310-792-1974
Practice Address - Street 1:4201 TORRANCE BLVD.
Practice Address - Street 2:SUITE 420
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503
Practice Address - Country:US
Practice Address - Phone:310-540-1953
Practice Address - Fax:310-792-1974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9791207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty