Organization
CENTRO MEDICO DEL VALLE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ENRIQUE S LOPEZ MD (OWNER)
(623) 873-1200
Entity
Organization
Contact information
Practice address
2929 N 75TH AVE, SUITE 5, PHOENIX, AZ 85033-5400
(623) 873-1200
(623) 873-1300
Mailing address
2929 N 75TH AVE, SUITE 5, PHOENIX, AZ 85033-5400
(623) 873-1200
(623) 873-1300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35764
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
462677
—
AZ
Enumeration date
09/22/2009
Last updated
02/17/2012
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