Provider Demographics
NPI:1457493165
Name:NORTH VALLEY EAR, NOSE & THROAT ASSOCIATES, P.C
Entity Type:Organization
Organization Name:NORTH VALLEY EAR, NOSE & THROAT ASSOCIATES, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:C
Authorized Official - Last Name:KAISER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-688-6500
Mailing Address - Street 1:3805 E. BELL ROAD
Mailing Address - Street 2:SUITE 5800
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2190
Mailing Address - Country:US
Mailing Address - Phone:602-688-8500
Mailing Address - Fax:602-867-3144
Practice Address - Street 1:3805 E. BELL ROAD
Practice Address - Street 2:SUITE 5800
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2190
Practice Address - Country:US
Practice Address - Phone:602-688-6500
Practice Address - Fax:602-867-3144
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH VALLEY EAR, NOSE & THROAT ASSOCIATES, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-12
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Y00000X
AZ22523207Y00000X
AZ32948207Y00000X
AZ3331207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZWMBCQMedicare PIN