Major Medical Management, Inc.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

E3817 Issued in CA

Legal business name

MAJOR MEDICAL MANAGEMENT, INC.

Doing business as

Valley Regional Surgery Center

Practice address

1510 S Central Ave
Ste 120
Glendale, CA 91204-2500

Phone

(818) 242-3668

NPI assigned

Jan 9, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Charles Blaine, DPM

Title

Podiatric Surgeon

Phone

(818) 242-3668

Specialties & licenses 1

Addresses

Other names 1

• Valley Regional Surgery Center Doing business as

Locations

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1942699236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14624 SHERMAN WAY",
            "address_2": "STE 306",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914052241",
            "telephone_number": "818-242-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 S CENTRAL AVE",
            "address_2": "STE 120",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042500",
            "telephone_number": "818-242-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAJOR MEDICAL MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-09",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "BLAINE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PODIATRIC SURGEON",
        "authorized_official_telephone_number": "818-242-3668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "E3817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Regional Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Leyla Malakian, D.C.
• Jacquiline P. Malanog, OTR

• Ambulatory Surgical Clinic/Center in Glendale, CA
• Providers in Glendale, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.