Healthcare Provider Details
I. General information
NPI: 1386129633
Provider Name (Legal Business Name): VALLEY SURGERY ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2018
Last Update Date: 10/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9458 E IRONWOOD SQUARE DR STE 101
SCOTTSDALE AZ
85258-4571
US
IV. Provider business mailing address
9500 E IRONWOOD SQUARE DR STE 110
SCOTTSDALE AZ
85258-4582
US
V. Phone/Fax
- Phone: 480-579-2060
- Fax: 480-579-2061
- Phone: 480-579-2060
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RAJAN
BHATT
Title or Position: MANAGER/MEMBER
Credential: MD
Phone: 480-948-8400