Provider Demographics
NPI:1215783980
Name:PRAEVALEO INC.
Entity type:Organization
Organization Name:PRAEVALEO INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WON
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT
Authorized Official - Phone:626-493-6328
Mailing Address - Street 1:500 N BRAND BLVD STE 490
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-1923
Mailing Address - Country:US
Mailing Address - Phone:888-266-1165
Mailing Address - Fax:818-279-2540
Practice Address - Street 1:500 N BRAND BLVD STE 490
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-1923
Practice Address - Country:US
Practice Address - Phone:888-266-1165
Practice Address - Fax:818-279-2540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy