MEDICARE: WEST VALLEY URGENT CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1821206343
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST VALLEY URGENT CARE

Provider Business Mailing Address
First Line	:	17218 N 72ND DR
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-8562
Country	:	US
Telephone Number	:	623-334-8670
Fax Number	:

Provider Business Practice Location Address
First Line	:	4110 N 108TH AVE STE 101
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85037-5772
Country	:	US
Telephone Number	:	623-334-8670
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. JEEVAN J PUNIA
Credential	:
Telephone Number	:	623-334-8670

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	08/22/2020

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Directions to “WEST VALLEY URGENT CARE ” Practice Location

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