Provider Demographics
NPI:1750434908
Name:VALLEY VIEW WELLNESS MEDICAL CENTER INC
Entity type:Organization
Organization Name:VALLEY VIEW WELLNESS MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:Z
Authorized Official - Last Name:KURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:714-897-9355
Mailing Address - Street 1:12495 VALLEY VIEW ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92845-2032
Mailing Address - Country:US
Mailing Address - Phone:714-897-9355
Mailing Address - Fax:
Practice Address - Street 1:12495 VALLEY VIEW ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845-2032
Practice Address - Country:US
Practice Address - Phone:714-897-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW20A4525BMedicare PIN
CA0187060001Medicare NSC
CAH75421Medicare UPIN
CAA93585Medicare UPIN
CAW20A7899AMedicare PIN
CAW14791Medicare PIN