# CENTRO MEDICO DEL VALLE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205160355
- **Authorized official:** DR. ENRIQUE S LOPEZ MD (OWNER)
- **Authorized official phone:** (623) 873-1200

## Contact information

- **Practice address:** 2929 N 75TH AVE, SUITE 5, PHOENIX, AZ 85033-5400
- **Practice address phone:** (623) 873-1200
- **Practice address fax:** (623) 873-1300
- **Mailing address:** 2929 N 75TH AVE, SUITE 5, PHOENIX, AZ 85033-5400
- **Mailing address phone:** (623) 873-1200
- **Mailing address fax:** (623) 873-1300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 35764 | AZ | Yes |

## Other

- **Enumeration date:** 09/22/2009
- **Last updated:** 02/17/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 462677 | — | AZ |