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General NPI Number Information
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NPI Number | 1477797710
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Entity Type | Organization
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Legal Business Name | DESERT VALLEY GASTROENTEROLOGY, LLC
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Dates
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Enumeration Date | 04/30/2009
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Last Update Date | 04/30/2009
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Provider Practice Location Address
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Address Line | 3921 E BASELINE RD SUITE 001
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City | GILBERT
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State | AZ
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Zip | 85234-2727
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Country | US
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Telephone | 480-306-6405
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Fax | 480-306-6409
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Provider Business Mailing Address
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Address Line | 3921 E BASELINE RD SUITE 001
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City | GILBERT
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State | AZ
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Zip | 85234-2727
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Country | US
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Telephone | 480-306-6405
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Fax | 480-306-6409
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. STEVEN C KAISER
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Credential | MD
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Telephone | 480-306-6405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 36236
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License Number State | AZ
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