Organization
SUN VALLEY INTERNIST LLC
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
14815 N DEL WEBB BLVD, #2, SUN CITY, AZ 85351-2145
(623) 977-3300
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
16317
AZ
Other
Enumeration date
01/02/2014
Last updated
01/02/2014
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