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NPI Code Detail

MEDICARE: VALLE DEL SOL, INC.

MEDICARE: VALLE DEL SOL, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1922527928
Entity Type Code : Organization
Provider Name (Legal Business Name) : VALLE DEL SOL, INC.
Provider Business Mailing Address
First Line : 3877 N 7TH ST STE 400
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-5061
Country : US
Telephone Number : 602-258-6797
Fax Number :
Provider Business Practice Location Address
First Line : 502 N 27TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85009-4420
Country : US
Telephone Number : 602-258-6797
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF CONTRACTS & LICENSING
Name : REBECCA RAZO
Credential :
Telephone Number : 602-258-6797
Provider Enumeration Date : 09/12/2017
Last Update Date : 06/07/2024

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