Provider Demographics
NPI:1538366018
Name:NORTH VALLEY PHYSICIANS GROUP, LLC
Entity type:Organization
Organization Name:NORTH VALLEY PHYSICIANS GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:SAYEGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-867-0111
Mailing Address - Street 1:18404 N TATUM BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-1510
Mailing Address - Country:US
Mailing Address - Phone:602-867-0111
Mailing Address - Fax:602-867-0121
Practice Address - Street 1:18404 N TATUM BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-1510
Practice Address - Country:US
Practice Address - Phone:602-867-0111
Practice Address - Fax:602-867-0121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18816207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty