Provider Demographics
NPI:1275643157
Name:DESERT VALLEY FAMILY MEDICINE
Entity Type:Organization
Organization Name:DESERT VALLEY FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:S
Authorized Official - Last Name:LAVEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:480-838-4277
Mailing Address - Street 1:2045 NORTH DOBSON RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-9601
Mailing Address - Country:US
Mailing Address - Phone:480-838-4277
Mailing Address - Fax:480-777-2331
Practice Address - Street 1:2045 N DOBSON RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-9601
Practice Address - Country:US
Practice Address - Phone:480-838-4277
Practice Address - Fax:480-777-2331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty