Healthcare Provider Details

I. General information

NPI: 1457493165
Provider Name (Legal Business Name): NORTH VALLEY EAR, NOSE & THROAT ASSOCIATES, P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3805 E. BELL ROAD SUITE 5800
PHOENIX AZ
85032-2190
US

IV. Provider business mailing address

3805 E. BELL ROAD SUITE 5800
PHOENIX AZ
85032-2190
US

V. Phone/Fax

Practice location:
  • Phone: 602-688-6500
  • Fax: 602-867-3144
Mailing address:
  • Phone: 602-688-8500
  • Fax: 602-867-3144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number32948
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number3331
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number22523
License Number StateAZ

VIII. Authorized Official

Name: DR. PETER C KAISER
Title or Position: OWNER
Credential: M.D.
Phone: 602-688-6500