Organization
WOMEN'S MEDICAL GROUP OF TEMPE
Active
Other names
East Valley Women's Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CLAUDIA MARIA SEVILLANO (SUPERVISOR/ BILLER)
(480) 632-2004
Entity
Organization
Contact information
Practice address
4915 E BASELINE RD STE 104, GILBERT, AZ 85234-2966
(480) 632-2004
Mailing address
4915 E BASELINE RD STE 104, GILBERT, AZ 85234-2966
(480) 632-2004
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
33219
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83790
MEDICARE PTAN
AZ
Enumeration date
06/25/2008
Last updated
10/15/2008
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