Healthcare Provider Details

I. General information

NPI: 1285660704
Provider Name (Legal Business Name): VALLEY ANESTHESIOLOGY CONSULTANTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2262 E ROSE GARDEN LN
PHOENIX AZ
85024-4497
US

IV. Provider business mailing address

PO BOX 740557 DEPT 10016
LOS ANGELES CA
90074-0557
US

V. Phone/Fax

Practice location:
  • Phone: 954-939-5000
  • Fax: 877-250-6889
Mailing address:
  • Phone: 954-939-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER KENNEDY
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 207-807-9009