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General NPI Number Information
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NPI Number | 1417142720
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Entity Type | Organization
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Legal Business Name | VIP HEALTH CENTER INC
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 11/16/2008
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Provider Practice Location Address
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Address Line | 7339 E WILLIAMS DR # 27255
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-4985
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Country | US
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Telephone | 480-560-8440
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Fax | 877-685-4673
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Provider Business Mailing Address
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Address Line | PO BOX 27255
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-0137
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Country | US
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Telephone | 480-560-8440
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Fax | 877-685-4673
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEYVAN KOOCHEK
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Credential | MD
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Telephone | 480-560-8440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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