| Valley Vista Medical Center | |
|
157 N Coronado Dr #c Sierra Vista AZ 85635-6360 | |
| (520) 458-0993 | |
| (520) 458-4402 |
| Full Name | Valley Vista Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 157 N Coronado Dr, Sierra Vista, Arizona |
| Authorized Official Name and Position | Archana Bansal (OWNER) |
| Authorized Official Contact | 5204580993 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Vista Medical Center 157 N Coronado Dr #c Sierra Vista AZ 85635-6360 Ph: (520) 458-0993 | Valley Vista Medical Center 157 N Coronado Dr #c Sierra Vista AZ 85635-6360 Ph: (520) 458-0993 |
| NPI Number | 1194084418 |
|---|---|
| Provider Enumeration Date | 05/07/2012 |
| Last Update Date | 11/13/2012 |
| Medicare PECOS PAC ID | 4880846732 |
|---|---|
| Medicare Enrollment ID | O20121129000120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194084418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35263 (Arizona) | Primary |
| Provider Name | Archana Bansal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881663615 PECOS PAC ID: 4981607173 Enrollment ID: I20060808000226 |
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