# SANTA CRUZ VALLEY PHYSICIAN GROUP LLC

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

## Provider details

- **NPI number:** 1568943561
- **Authorized official:** ZAMIA MOSMAN (HEALTH PLAN RELATIONS)
- **Authorized official phone:** (520) 405-9687

## Contact information

- **Practice address:** 4455 S I 19 FRONTAGE RD, GREEN VALLEY, AZ 85614-5884
- **Practice address phone:** (520) 393-4700
- **Practice address fax:** (520) 393-4923
- **Mailing address:** 4455 S I 19 FRONTAGE RD, GREEN VALLEY, AZ 85614-5884
- **Mailing address phone:** (520) 393-4700
- **Mailing address fax:** (520) 393-4923

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/27/2018
- **Last updated:** 04/14/2020