Provider Demographics
NPI:1952477275
Name:VALENCIA NEUROLOGY MEDICAL GROUP INC
Entity Type:Organization
Organization Name:VALENCIA NEUROLOGY MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:SURISHAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DHILLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-222-2326
Mailing Address - Street 1:23928 LYONS AVE
Mailing Address - Street 2:#102
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321
Mailing Address - Country:US
Mailing Address - Phone:661-222-2326
Mailing Address - Fax:661-222-9444
Practice Address - Street 1:23928 LYONS AVE
Practice Address - Street 2:#102
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321
Practice Address - Country:US
Practice Address - Phone:661-222-2326
Practice Address - Fax:661-222-9444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6507231OtherMEDICAL
WA51651AMedicare ID - Type Unspecified
W15694Medicare ID - Type Unspecified
6507231OtherMEDICAL