Organization
EVAN JONATHAN VALLE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN JONATHAN VALLEY M.D. (PRESIDENT)
(650) 201-1026
Entity
Organization
Contact information
Practice address
15031 RINALDI ST, MISSION HILLS, CA 91345-1207
(818) 365-8051
Mailing address
35 E GLENARM ST, PASADENA, CA 91105-3418
(626) 768-4415
(626) 403-0321
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A147393
CA MED LICENSE
CA
Enumeration date
06/17/2019
Last updated
06/17/2019
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