Midvalley Medical Center Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MIDVALLEY MEDICAL CENTER INC.

Practice address

14550 Archwood St # 106
Van Nuys, CA 91405-4604

Phone

(818) 951-5540

Fax

(818) 851-5544

NPI assigned

May 12, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Elsagav Shaham

Title

MD

Phone

(818) 851-5540

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652313600000",
    "number": "1821734732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14550 ARCHWOOD ST # 106",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054604",
            "telephone_number": "818-951-5540",
            "fax_number": "818-851-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14550 ARCHWOOD ST # 106",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054604",
            "telephone_number": "818-951-5540",
            "fax_number": "818-851-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDVALLEY MEDICAL CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A",
        "authorized_official_last_name": "SHAHAM",
        "authorized_official_first_name": "ELSAGAV",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "818-851-5540",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.