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Organization
MAJOR MEDICAL MANAGEMENT, INC.
Active
Organization
MAJOR MEDICAL MANAGEMENT, INC.
Active
Other names
Valley Regional Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES BLAINE DPM (PODIATRIC SURGEON)
(818) 242-3668
Entity
Organization
Contact information
Practice address
1510 S CENTRAL AVE, STE 120, GLENDALE, CA 91204-2500
(818) 242-3668
Mailing address
14624 SHERMAN WAY, STE 306, VAN NUYS, CA 91405-2241
(818) 242-3668
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
E3817
CA
Other
Enumeration date
01/09/2015
Last updated
01/09/2015
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