Organization
ASSOCIATED VALLEY RADIOLOGISTS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN VAUGHN (VICE PRESIDENT, PROVIDER ENROLLMENT)
(330) 309-6984
Entity
Organization
Contact information
Practice address
5605 W EUGIE AVE STE 110, GLENDALE, AZ 85304-1273
(888) 571-7818
Mailing address
PO BOX 74134, LOS ANGELES, CA 90074-1734
(602) 521-6252
(623) 842-5640
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
468437
—
AZ
Enumeration date
09/21/2018
Last updated
08/14/2025
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