Basic Information
Provider Information
NPI: 1437173382
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VALENCIA
FirstName: ARWIN
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2801 ATLANTIC AVE
Address2: 2ND FLOOR, NICU
City: LONG BEACH
State: CA
PostalCode: 908061701
CountryCode: US
TelephoneNumber: 5629338100
FaxNumber: 5629338014
Practice Location
Address1: 2801 ATLANTIC AVE
Address2: 2ND FLOOR, NICU
City: LONG BEACH
State: CA
PostalCode: 908061701
CountryCode: US
TelephoneNumber: 5629338100
FaxNumber: 5629338014
Other Information
ProviderEnumerationDate: 07/26/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080N0001XA71301CAY Allopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine

No ID Information.


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