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General NPI Number Information
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NPI Number | 1154320349
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Entity Type | Organization
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Legal Business Name | VALLEY PHYSICIANS, LLC
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 07/26/2010
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Provider Practice Location Address
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Address Line | 1728 W GLENDALE AVE SUITE 403
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City | PHOENIX
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State | AZ
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Zip | 85021-8860
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Country | US
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Telephone | 602-995-3400
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Fax | 602-995-3404
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Provider Business Mailing Address
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Address Line | 1728 W GLENDALE AVE SUITE 403
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City | PHOENIX
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State | AZ
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Zip | 85021-8860
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Country | US
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Telephone | 602-995-3400
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Fax | 602-995-3404
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ROSARIO P YLAGAN
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Credential |
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Telephone | 602-995-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 19823
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License Number State | AZ
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