| Pvhc At Chino Hills | |
|
2140 Grand Ave Ste 125 Chino Hills CA 91709-6802 | |
| (909) 630-7875 | |
| (909) 630-7876 |
| Full Name | Pvhc At Chino Hills |
|---|---|
| Speciality | Clinic/center - Health Service |
| Location | 2140 Grand Ave Ste 125, Chino Hills, California |
| Authorized Official Name and Position | Maria Leticia Valadez (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9096307875 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pvhc At Chino Hills 2140 Grand Ave Ste 125 Chino Hills CA 91709-6802 Ph: (909) 630-7875 | Pvhc At Chino Hills 2140 Grand Ave Ste 125 Chino Hills CA 91709-6802 Ph: (909) 630-7875 |
| NPI Number | 1730112426 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 07/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730112426 | NPI | - | NPPES |
| 1730112426 | Medicaid | CA | |
| 05D0977154 | Other | CA | CLIA # |
| 240000815 | Other | DHS CERT | |
| ZZZ07684Z | Other | BLUE SHIELD OF CALIFORNIA | |
| ZZZ25560Z | Other | CA | MEDICARE GROUP # FOR NO- CAL |
| GR0083731 | Medicaid | CA | |
| DF6140 | Other | RAILROAD | |
| 06 05671 | Other | CO | CHINO HILLS BUSINESS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (California) | Secondary |
| 261QH0100X | Clinic/center - Health Service | 550000 (California) | Primary |
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