Basic Information
| Provider Information | |||||||||
| NPI: | 1043224322 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VALLEY EMERGENCY PHYSICIANS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 40610 | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85274 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808393313 | ||||||||
| FaxNumber: | 4808394182 | ||||||||
| Practice Location | |||||||||
| Address1: | 5102 W CAMPBELL AVENUE | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6238485000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SCHWARTZ | ||||||||
| AuthorizedOfficialFirstName: | ALAN | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4807682228 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | AZ | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 995409 | 05 | AZ | MEDICAID |