Provider Demographics
NPI:1265526420
Name:MEDICAL VALLEY PARTNERS, INC.
Entity type:Organization
Organization Name:MEDICAL VALLEY PARTNERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWIEGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-757-1212
Mailing Address - Street 1:18375 VENTURA BLVD STE 628
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4218
Mailing Address - Country:US
Mailing Address - Phone:818-757-1212
Mailing Address - Fax:818-757-1520
Practice Address - Street 1:18840 VENTURA BLVD STE 207
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3381
Practice Address - Country:US
Practice Address - Phone:818-757-1212
Practice Address - Fax:818-757-1520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44951207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID