Provider Demographics
NPI:1245758051
Name:WEST VALLEY ENDOCRINOLOGY, DIABETES AND METABOLISM CENTER LLC
Entity Type:Organization
Organization Name:WEST VALLEY ENDOCRINOLOGY, DIABETES AND METABOLISM CENTER LLC
Other - Org Name:SUZI KOCHAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZI
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-398-2222
Mailing Address - Street 1:14175 W INDIAN SCHOOL RD STE B4-619
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-8407
Mailing Address - Country:US
Mailing Address - Phone:623-398-2222
Mailing Address - Fax:
Practice Address - Street 1:3000 N LITCHFIELD RD STE 120
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-7802
Practice Address - Country:US
Practice Address - Phone:623-282-4078
Practice Address - Fax:888-880-1168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-31
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ50967207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty