| Madeleine M Valencerina Md Inc | |
|
14730 Beach Blvd Suite 123 La Mirada CA 90638 | |
| (714) 521-8262 | |
| (562) 690-5330 |
| Full Name | Madeleine M Valencerina Md Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 14730 Beach Blvd, La Mirada, California |
| Authorized Official Name and Position | Madeleine M Valencerina (OWNER PROVIDER) |
| Authorized Official Contact | 7145218262 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Madeleine M Valencerina Md Inc Po Box 4500 Cerritos CA 90703-4500 Ph: (714) 521-8262 | Madeleine M Valencerina Md Inc 14730 Beach Blvd Suite 123 La Mirada CA 90638 Ph: (714) 521-8262 |
| NPI Number | 1043370158 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 06/24/2015 |
| Medicare PECOS PAC ID | 0244406668 |
|---|---|
| Medicare Enrollment ID | O20120105000465 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043370158 | NPI | - | NPPES |
| 00A510430 | Other | CA | BLUE SHIELD |
| 00A510431 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A51043 (California) | Primary |
| Provider Name | Madeleine M Valencerina |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437284809 PECOS PAC ID: 9436330735 Enrollment ID: I20110218000960 |
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