Provider Demographics
NPI:1285660704
Name:VALLEY ANESTHESIOLOGY CONSULTANTS, INC.
Entity type:Organization
Organization Name:VALLEY ANESTHESIOLOGY CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-807-9009
Mailing Address - Street 1:PO BOX 740557
Mailing Address - Street 2:DEPT 10016
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-0557
Mailing Address - Country:US
Mailing Address - Phone:954-939-5000
Mailing Address - Fax:
Practice Address - Street 1:2262 E ROSE GARDEN LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-4497
Practice Address - Country:US
Practice Address - Phone:954-939-5000
Practice Address - Fax:877-250-6889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ101065Medicaid
AZZWCHKJMedicare PIN