Provider Demographics
NPI:1952597031
Name:CARLTON F VALVO M D, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:CARLTON F VALVO M D, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLTON
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:VALVO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-242-1932
Mailing Address - Street 1:PO BOX 668
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91021-0668
Mailing Address - Country:US
Mailing Address - Phone:818-242-1932
Mailing Address - Fax:818-242-9462
Practice Address - Street 1:1808 VERDUGO BLVD STE 110
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-1450
Practice Address - Country:US
Practice Address - Phone:818-242-1932
Practice Address - Fax:818-242-9462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC025647208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW1213Medicare PIN