Healthcare Provider Details

I. General information

NPI: 1124982293
Provider Name (Legal Business Name): EAST VALLEY INTEGRATED HOSPITALIST PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6750 E BAYWOOD AVE # 402
MESA AZ
85206-1749
US

IV. Provider business mailing address

6750 E BAYWOOD AVE # 402
MESA AZ
85206-1749
US

V. Phone/Fax

Practice location:
  • Phone: 480-943-1220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. BAHAR VURAL
Title or Position: CFO
Credential: CFO
Phone: 347-445-9294