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General NPI Number Information
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NPI Number | 1528431715
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Entity Type | Organization
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Legal Business Name | WEST VALLEY FOOT AND ANKLE
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Dates
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Enumeration Date | 11/10/2015
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Last Update Date | 11/10/2015
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Provider Practice Location Address
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Address Line | 13540 W CAMINO DEL SOL SUITE 15
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City | SUN CITY
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State | AZ
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Zip | 85375-4434
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Country | US
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Telephone | 623-214-1602
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Fax | 623-544-0701
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Provider Business Mailing Address
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Address Line | 13540 W CAMINO DEL SOL SUITE 15
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City | SUN CITY
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State | AZ
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Zip | 85375-4434
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Country | US
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Telephone | 623-214-1602
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Fax | 623-544-0701
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Authorized Official
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Title or Position | OWNER
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Name | JEFFREY WEISS
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Credential |
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Telephone | 623-214-1602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 450
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License Number State | AZ
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