| Centro Medico Del Valle Pc | |
|
2929 N 75th Ave Suite 5 Phoenix AZ 85033-5400 | |
| (623) 873-1200 | |
| (623) 873-1300 |
| Full Name | Centro Medico Del Valle Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2929 N 75th Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Enrique S Lopez (OWNER) |
| Authorized Official Contact | 6238731200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centro Medico Del Valle Pc 2929 N 75th Ave Suite 5 Phoenix AZ 85033-5400 Ph: (623) 873-1200 | Centro Medico Del Valle Pc 2929 N 75th Ave Suite 5 Phoenix AZ 85033-5400 Ph: (623) 873-1200 |
| NPI Number | 1205160355 |
|---|---|
| Provider Enumeration Date | 09/22/2009 |
| Last Update Date | 02/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205160355 | NPI | - | NPPES |
| 462677 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35764 (Arizona) | Primary |
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