Healthcare Provider Details
I. General information
NPI: 1013235845
Provider Name (Legal Business Name): ANGELA MONIQUE VALDEZ-HUIZAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/04/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3333 E VAN BUREN ST
PHOENIX AZ
85008-6812
US
IV. Provider business mailing address
3200 E CAMELBACK RD STE 250
PHOENIX AZ
85018-2327
US
V. Phone/Fax
- Phone: 602-933-0945
- Fax: 602-933-4263
- Phone: 602-933-1814
- Fax: 602-933-1820
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 47667 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: