Healthcare Provider Details

I. General information

NPI: 1699830570
Provider Name (Legal Business Name): VALLEY MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2034 E SOUTHERN AVE SUITE M
TEMPE AZ
85282-7522
US

IV. Provider business mailing address

1753 E BROADWAY RD STE 101-268
TEMPE AZ
85282-2081
US

V. Phone/Fax

Practice location:
  • Phone: 800-836-2904
  • Fax:
Mailing address:
  • Phone: 800-836-2094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MS. LINDA H STARR
Title or Position: DIRECTOR
Credential:
Phone: 800-836-2904