Valley Physicians Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

GH4008 Issued in CA

Legal business name

VALLEY PHYSICIANS MEDICAL GROUP, INC.

Practice address

841 W Valley Blvd
Suite 104
Alhambra, CA 91803-3251

Phone

(626) 282-3113

Fax

(626) 289-9179

NPI assigned

Sep 16, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Prasert Basil Vassantachart, MD

Title

Owner

Phone

(626) 282-3113

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Prasert Basil Vassantachart, MD

  • General Practice Physician
  • Alhambra, CA
  • NPI 1295720050
  Medicare reassignment NPD
• Prasert Basil Vassantachart Jr., PHARMD

  • Pharmacist
  • Alhambra, CA
  • NPI 1811246325
  NPD (past)

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314835200000",
    "number": "1376538132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 W VALLEY BLVD",
            "address_2": "SUITE 104",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918033251",
            "telephone_number": "626-282-3113",
            "fax_number": "626-289-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 W VALLEY BLVD",
            "address_2": "SUITE 104",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918033251",
            "telephone_number": "626-282-3113",
            "fax_number": "626-289-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY PHYSICIANS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-16",
        "last_updated": "2011-09-01",
        "status": "A",
        "authorized_official_last_name": "VASSANTACHART",
        "authorized_official_first_name": "PRASERT",
        "authorized_official_middle_name": "BASIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-282-3113",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "GH4008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0016470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Valencia Granillo, RDN
• Yesenia Valentin
• Jacqueline Valle
• Joshua Valle
• Crystal Denise Valles
• Aylin Esmeralda Valtierra
• Jenny Van Den Bosch
• Tonny Van
• Christina Varela, OTR/L
• Edgar Varela

• Family Medicine Physician in Alhambra, CA
• Providers in Alhambra, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.