1043461437 NPI number — ARIZONA CANCER SPECIALISTS PLC

Table of content: (NPI 1043461437)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043461437 NPI number — ARIZONA CANCER SPECIALISTS PLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARIZONA CANCER SPECIALISTS PLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043461437
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3106
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90078-3106
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-922-4600
Provider Business Mailing Address Fax Number:
480-955-5231

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9055 E. DEL CAMINO
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85258
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-922-4600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/04/2008

Additional Information

Authorized Official

Authorized Official Last Name:
QUIET
Authorized Official First Name:
CORAL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
480-922-4600

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 395133 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".




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