Provider Demographics
NPI:1447339890
Name:VALLEY INTERNAL MEDICINE AND PEDIATRICS, P.C.
Entity type:Organization
Organization Name:VALLEY INTERNAL MEDICINE AND PEDIATRICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:G
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-991-5088
Mailing Address - Street 1:10900 N SCOTTSDALE RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5216
Mailing Address - Country:US
Mailing Address - Phone:480-991-5088
Mailing Address - Fax:480-367-1361
Practice Address - Street 1:10900 N SCOTTSDALE RD
Practice Address - Street 2:SUITE 206
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5216
Practice Address - Country:US
Practice Address - Phone:480-991-5088
Practice Address - Fax:480-367-1361
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY INTERNAL MEDICINE AND PEDIATRICS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-06
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ70533Medicare ID - Type UnspecifiedPROVIDER NUMBER