Healthcare Provider Details
I. General information
NPI: 1922204155
Provider Name (Legal Business Name): WESTVIEW FAMILY MEDICINE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/25/2007
Last Update Date: 02/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13065 W MCDOWELL RD A-105
AVONDALE AZ
85323-6439
US
IV. Provider business mailing address
P.O. BOX 7310
PHOENIX AZ
85011-7310
US
V. Phone/Fax
- Phone: 623-536-6788
- Fax: 623-536-9288
- Phone: 623-536-6788
- Fax: 623-536-9288
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 23025 |
| License Number State | AZ |
VIII. Authorized Official
Name:
SALLY
JO ANN
GARCIA
Title or Position: OFFICE MANAGER
Credential:
Phone: 623-536-6788