Healthcare Provider Details
I. General information
NPI: 1689712390
Provider Name (Legal Business Name): NORTH VALLEY OBSTETRICS AND GYNECOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
19841 N 27TH AVE 204
PHOENIX AZ
85027-4003
US
IV. Provider business mailing address
19841 N 27TH AVE 204
PHOENIX AZ
85027-4003
US
V. Phone/Fax
- Phone: 623-780-0100
- Fax: 623-492-9160
- Phone: 623-780-0100
- Fax: 623-492-9160
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 2283 |
| License Number State | AZ |
VIII. Authorized Official
Name: DR.
ARLENE
ENGLAND
Title or Position: OWNER
Credential: D.O.
Phone: 623-780-0100