Provider Demographics
NPI:1245265495
Name:VALDEZ, ANTHONY A (MD)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:A
Last Name:VALDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3807 UNION AVE
Mailing Address - Street 2:STE B
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305
Mailing Address - Country:US
Mailing Address - Phone:661-324-2423
Mailing Address - Fax:661-324-0823
Practice Address - Street 1:3807 UNION AVE
Practice Address - Street 2:STE B
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305
Practice Address - Country:US
Practice Address - Phone:661-324-2423
Practice Address - Fax:661-324-0823
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG444030207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G444030Medicaid
A49638Medicare UPIN
CA00G444030Medicare ID - Type Unspecified