# MAJOR MEDICAL MANAGEMENT, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Valley Regional Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942699236
- **Authorized official:** DR. CHARLES BLAINE DPM (PODIATRIC SURGEON)
- **Authorized official phone:** (818) 242-3668

## Contact information

- **Practice address:** 1510 S CENTRAL AVE, STE 120, GLENDALE, CA 91204-2500
- **Practice address phone:** (818) 242-3668
- **Mailing address:** 14624 SHERMAN WAY, STE 306, VAN NUYS, CA 91405-2241
- **Mailing address phone:** (818) 242-3668

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | E3817 | CA | Yes |

## Other

- **Enumeration date:** 01/09/2015
- **Last updated:** 01/09/2015