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General NPI Number Information
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NPI Number | 1992788566
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Entity Type | Individual
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Provider Name | VIVIAN MONIQUE MCCORVEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 100 W CALIFORNIA BLVD
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City | PASADENA
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State | CA
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Zip | 91105-3010
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Country | US
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Telephone | 626-397-5139
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Fax | 626-397-2190
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Provider Business Mailing Address
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Address Line | 7304 E DEER VALLEY RD STE 105
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-7459
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Country | US
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Telephone | 602-651-1901
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Fax | 602-749-8613
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 39640
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 53565
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License Number State | CA
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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 | 41020
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License Number State | AZ
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