Provider Demographics
NPI:1992970073
Name:DEER VALLEY ANESTHESIA, PLLC
Entity type:Organization
Organization Name:DEER VALLEY ANESTHESIA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-931-1225
Mailing Address - Street 1:PO BOX 81349
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85069-1349
Mailing Address - Country:US
Mailing Address - Phone:623-931-1225
Mailing Address - Fax:623-931-0088
Practice Address - Street 1:19829 N 27TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4001
Practice Address - Country:US
Practice Address - Phone:623-931-1225
Practice Address - Fax:623-931-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty