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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