Organization
VALLEY RETINA ASSOCIATES MEDICAL GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRY FLEMING COE (ADMINISTRATOR)
(818) 788-9333
Entity
Organization
Contact information
Practice address
16500 VENTURA BLVD, SUITE 250, ENCINO, CA 91436-2011
(818) 788-9333
(818) 788-9273
Mailing address
16500 VENTURA BLVD, SUITE 250, ENCINO, CA 91436-2011
(818) 788-9333
(818) 788-9273
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G69965
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0099160
—
CA
Enumeration date
01/17/2007
Last updated
02/27/2008
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