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General NPI Number Information
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NPI Number | 1932683257
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Entity Type | Organization
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Legal Business Name | ASSOCIATED VALLEY RADIOLOGISTS LTD
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Dates
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Enumeration Date | 09/21/2018
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 5605 W EUGIE AVE STE 110
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City | GLENDALE
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State | AZ
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Zip | 85304-1273
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Country | US
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Telephone | 888-571-7818
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 74134
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City | LOS ANGELES
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State | CA
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Zip | 90074-1734
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Country | US
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Telephone | 602-521-6252
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Fax | 623-842-5640
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Authorized Official
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Title or Position | VICE PRESIDENT, PROVIDER ENROLLMENT
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Name | KAREN VAUGHN
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Credential |
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Telephone | 330-309-6984
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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