Healthcare Provider Details
I. General information
NPI: 1225494131
Provider Name (Legal Business Name): VALLEY SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/07/2016
Last Update Date: 07/21/2022
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
PO BOX 847128
LOS ANGELES CA
90084-7128
US
V. Phone/Fax
- Phone: 480-579-2060
- Fax: 480-579-2061
- Phone: 480-579-2060
- Fax: 480-579-2061
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | OSC8721 |
| License Number State | AZ |
VIII. Authorized Official
Name:
RAJAN
BHATT
Title or Position: MANAGER/OWNER
Credential: MD
Phone: 480-948-8400