Provider Demographics
NPI:1396747754
Name:MYERS, VALERIE PHILLIPS (MD)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:PHILLIPS
Last Name:MYERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CONGRESS ST
Mailing Address - Street 2:STE 400
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3023
Mailing Address - Country:US
Mailing Address - Phone:626-449-6223
Mailing Address - Fax:626-449-0035
Practice Address - Street 1:10 CONGRESS ST
Practice Address - Street 2:STE 400
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3023
Practice Address - Country:US
Practice Address - Phone:626-449-6223
Practice Address - Fax:626-449-0035
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52632207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFJ110AOtherPTAN
CAFJ110AOtherMEDICARE PTAN
CAFJ110AOtherPTAN