Provider Demographics
NPI:1598139883
Name:VALLEY PEDIATRIC HEALTH
Entity type:Organization
Organization Name:VALLEY PEDIATRIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:AMEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSHAREEF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-767-5659
Mailing Address - Street 1:1600 S IMPERIAL AVE
Mailing Address - Street 2:10
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-4242
Mailing Address - Country:US
Mailing Address - Phone:760-970-4862
Mailing Address - Fax:
Practice Address - Street 1:1446 W. PICO AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243
Practice Address - Country:US
Practice Address - Phone:760-970-4862
Practice Address - Fax:760-970-4373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA123164208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty