SOUTH VAL VISTA MEDICAL GROUP LLC NPI 1861855462

NPI Information

SOUTH VAL VISTA MEDICAL GROUP LLC is a medical physician assistant in Gilbert, AZ. SOUTH VAL VISTA MEDICAL GROUP LLC NPI is 1861855462. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

754 S. VAL VISTA DR.
#105
GILBERT, AZ
ZIP 85296
Phone: (480) 497-2900
Fax: (480) 926-2260

The provider's authorized official is Greg J Vogel .
The authorized official title is Owner Manager and has the following contact phone number (480) 497-2900.

The CLIA number assigned to this NPI record is 03D2153572 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/31/2016 and was last updated on 3/31/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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