Valley Infections Disease Medical Group Inc a Medical Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

License

G29880 Issued in CA

Legal business name

VALLEY INFECTIONS DISEASE MEDICAL GROUP INC A MEDICAL CORPORATION

Practice address

23928 Lyons Ave
#208
Newhall, CA 91321-2409

Phone

(661) 255-8544

Fax

(661) 255-9964

NPI assigned

Jul 6, 2006

Last updated

May 10, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ellsworth Paxton Pryor, III, M.D

Title

President

Phone

(661) 255-8544

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1043241136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23928 LYONS AVE",
            "address_2": "#208",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913212409",
            "telephone_number": "661-255-8544",
            "fax_number": "661-255-9964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23928 LYONS AVE",
            "address_2": "#208",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913212409",
            "telephone_number": "661-255-8544",
            "fax_number": "661-255-9964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY INFECTIONS DISEASE MEDICAL GROUP INC A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "PRYOR, III",
        "authorized_official_first_name": "ELLSWORTH",
        "authorized_official_middle_name": "PAXTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-255-8544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G29880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G298800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Alan Upham, D.D.S.
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• Valencia Pulmonary Medical Group Inc.
• Valley Institute of Prosthetics & Orthotics, Inc
• Andrea Van Deventer, BCBA
• James Matthew Vangrinsven, D.C.
• Samantha Veil
• Fabiana Vela

• Specialist in Newhall, CA
• Providers in Newhall, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.