Provider Demographics
NPI:1942219167
Name:ALL VALLEY PEDIATRICS
Entity Type:Organization
Organization Name:ALL VALLEY PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMASHIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-365-7783
Mailing Address - Street 1:14901 RINALDI ST
Mailing Address - Street 2:STE 300
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-1204
Mailing Address - Country:US
Mailing Address - Phone:818-365-7783
Mailing Address - Fax:818-365-2193
Practice Address - Street 1:14901 RINALDI ST
Practice Address - Street 2:STE 300
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1204
Practice Address - Country:US
Practice Address - Phone:818-365-7783
Practice Address - Fax:818-365-2193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0092820Medicaid