| Sun Valley Family Care Pc | |
|
1762 W Bell Rd Phoenix AZ 85023-3414 | |
| (602) 504-6058 | |
| (602) 485-5156 |
| Full Name | Sun Valley Family Care Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1762 W Bell Rd, Phoenix, Arizona |
| Authorized Official Name and Position | Kumar Daulat (PHYSICIAN) |
| Authorized Official Contact | 6024933677 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sun Valley Family Care Pc 16601 N 40th St Suite 121 Phoenix AZ 85032-3345 Ph: (602) 493-3677 | Sun Valley Family Care Pc 1762 W Bell Rd Phoenix AZ 85023-3414 Ph: (602) 504-6058 |
| NPI Number | 1992078711 |
|---|---|
| Provider Enumeration Date | 02/10/2012 |
| Last Update Date | 04/17/2018 |
| Medicare PECOS PAC ID | 3779846118 |
|---|---|
| Medicare Enrollment ID | O20180417001055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992078711 | NPI | - | NPPES |
| 182874 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2635 (Arizona) | Primary |
| Provider Name | Kumar P Daulat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992847651 PECOS PAC ID: 7315965514 Enrollment ID: I20051107000296 |
| Provider Name | Aurea Maridia Castellanos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427562909 PECOS PAC ID: 7618232448 Enrollment ID: I20180529002323 |
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