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General NPI Number Information
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NPI Number | 1346301835
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Entity Type | Organization
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Legal Business Name | DESERT VIEW CLINIC INC
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 11361 N 99 AVE 101
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City | PEORIA
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State | AZ
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Zip | 85345
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Country | US
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Telephone | 623-875-1328
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Fax | 623-875-4196
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Provider Business Mailing Address
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Address Line | 11361 N 99 AVE 101
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City | PEORIA
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State | AZ
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Zip | 85345
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Country | US
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Telephone | 623-875-1328
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Fax | 623-875-4196
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Authorized Official
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Title or Position | ADM PRESIDENT
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Name | MS. GEORGIA ANN DAVIS
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Credential |
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Telephone | 623-875-1328
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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 | 1916
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT02472P
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT05297P
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License Number State | AZ
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