Healthcare Provider Details

I. General information

NPI: 1154318699
Provider Name (Legal Business Name): MICHELLE VALENZUELA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE COMSTOCK VALENZUELA MD

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3805 E BELL RD SUITE 5100
PHOENIX AZ
85032
US

IV. Provider business mailing address

205 S DOBSON RD SUITE 1
CHANDLER AZ
85224-6183
US

V. Phone/Fax

Practice location:
  • Phone: 602-923-7730
  • Fax: 602-930-7833
Mailing address:
  • Phone: 480-963-6668
  • Fax: 480-963-6669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number33580
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: