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General NPI Number Information
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NPI Number | 1033324595
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Entity Type | Organization
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Legal Business Name | WEST VALLEY COLON AND RECTAL SURGERY CENTER, LLC
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 11/21/2007
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Provider Practice Location Address
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Address Line | 10503 W THUNDERBIRD BLVD SUITE 114
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City | SUN CITY
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State | AZ
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Zip | 85351-3022
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Country | US
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Telephone | 623-875-7330
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Fax |
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Provider Business Mailing Address
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Address Line | 10503 WEST THUNDERBIRD BLVD. SUITE 114
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City | SUN CITY
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State | AZ
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Zip | 85351
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Country | US
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Telephone | 623-875-7330
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. HADI RAZAVI NAJAFIAN
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Credential | D.O
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Telephone | 623-875-7330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 4626
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License Number State | AZ
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