Organization
VALLEY KIDNEY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAHADUR SAMRA (ADMINISTRATOR)
(602) 564-0047
Entity
Organization
Contact information
Practice address
13943 N 91ST AVE, STE H101, PEORIA, AZ 85381-3689
(623) 977-1331
(623) 977-1449
Mailing address
5150 N 16TH ST, STE B232, PHOENIX, AZ 85016-3990
(623) 977-1331
(623) 977-1449
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
333266
—
AZ
Enumeration date
05/23/2006
Last updated
06/01/2012
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