1235326174 NPI number — WARREN C RIZZO MD PC

Table of content: (NPI 1235326174)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235326174 NPI number — WARREN C RIZZO MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WARREN C RIZZO MD PC
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:
1235326174
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10210 N 92ND ST
Provider Second Line Business Mailing Address:
SUITE 105
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85258-4509
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-451-3222
Provider Business Mailing Address Fax Number:
480-451-3224

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10210 N 92ND ST
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85258-4509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-451-3222
Provider Business Practice Location Address Fax Number:
480-451-3224
Provider Enumeration Date:
09/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RIZZO
Authorized Official First Name:
WARREN
Authorized Official Middle Name:
C
Authorized Official Title or Position:
OWNER/PHYSICIAN
Authorized Official Telephone Number:
480-451-3222

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  28981 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1Z6190 . This is a "HEALTHNET" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: AHCCCS . This is a "563826" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 7686072 . This is a "AETNA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 3200086 . This is a "UHC" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 5403601 . This is a "CCN" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 563826 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: AZ0726620 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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