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Individual
DR. NASA VALENTINE
Active
Individual
DR. NASA VALENTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036121819
IL
207Q00000X
Family Medicine Physician
Primary
A102556
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036121819
ILLINIOIS STATE LICENSE
IL
01
—
A102256
CALIFORNIA STATE LICENSE
CA
Enumeration date
07/15/2008
Last updated
10/16/2021
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