Provider Demographics
NPI:1821191008
Name:WEST VALLEY EAR NOSE AND THROAT PC
Entity Type:Organization
Organization Name:WEST VALLEY EAR NOSE AND THROAT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:RIZZO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:602-843-4844
Mailing Address - Street 1:3201 W PEORIA AVE
Mailing Address - Street 2:STE D704
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4608
Mailing Address - Country:US
Mailing Address - Phone:602-843-4844
Mailing Address - Fax:602-843-4846
Practice Address - Street 1:3201 W PEORIA AVE
Practice Address - Street 2:STE D704
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4608
Practice Address - Country:US
Practice Address - Phone:602-843-4844
Practice Address - Fax:602-843-4846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3597207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty