Provider Demographics
NPI:1447942743
Name:VALLEY HEALTH TEAM, INC
Entity type:Organization
Organization Name:VALLEY HEALTH TEAM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STUDENT IN AN ORGANIZED HEALTH CARE
Authorized Official - Prefix:DR
Authorized Official - First Name:TEWODROS
Authorized Official - Middle Name:KEBEDE
Authorized Official - Last Name:TEKLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-203-6640
Mailing Address - Street 1:4711 W ASHLAN AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-4307
Mailing Address - Country:US
Mailing Address - Phone:559-203-6640
Mailing Address - Fax:
Practice Address - Street 1:4711 W ASHLAN AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-4307
Practice Address - Country:US
Practice Address - Phone:559-203-6640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty