Provider Demographics
NPI:1639198674
Name:VALLEY PRIMARY CARE PHYSICIANS, LLC
Entity Type:Organization
Organization Name:VALLEY PRIMARY CARE PHYSICIANS, LLC
Other - Org Name:VALLEY PRIMARY CARE PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAZEM
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTAMEDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-864-6828
Mailing Address - Street 1:1728 W GLENDALE AVE
Mailing Address - Street 2:STE 301
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021
Mailing Address - Country:US
Mailing Address - Phone:602-864-6828
Mailing Address - Fax:602-864-8889
Practice Address - Street 1:1728 W GLENDALE AVE
Practice Address - Street 2:STE 301
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021
Practice Address - Country:US
Practice Address - Phone:602-864-6828
Practice Address - Fax:602-864-8889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty