Provider Demographics
NPI:1881769578
Name:NOVAK, VALERIE (MD)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:
Last Name:NOVAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:NOVAK
Other - Last Name:SHELINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1048 SAGEBRUSH RD
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-3974
Mailing Address - Country:US
Mailing Address - Phone:760-929-9631
Mailing Address - Fax:
Practice Address - Street 1:1048 SAGEBRUSH RD
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-3974
Practice Address - Country:US
Practice Address - Phone:760-929-9631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG43090207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine