Healthcare Provider Details

I. General information

NPI: 1750589404
Provider Name (Legal Business Name): ARIZONA OB GYN AFFILIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2007
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 E CAMELBACK RD STE 160
PHOENIX AZ
85016-3921
US

IV. Provider business mailing address

1661 E CAMELBACK RD STE 200
PHOENIX AZ
85016-3913
US

V. Phone/Fax

Practice location:
  • Phone: 623-231-3686
  • Fax:
Mailing address:
  • Phone: 623-231-3686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDREW VILLA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 623-231-3686