MEDICARE: NORTH DESERT CONSULTANTS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1013507946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH DESERT CONSULTANTS LLC

Provider Business Mailing Address
First Line	:	14072 N 111TH PL
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-1633
Country	:	US
Telephone Number	:	602-621-3853
Fax Number	:

Provider Business Practice Location Address
First Line	:	9301 W THOMAS RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85037-3327
Country	:	US
Telephone Number	:	623-213-7407
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER
Name	:	AJAY KUMAR MATHUR
Credential	:	MD
Telephone Number	:	602-621-3853

Provider Enumeration Date	:	01/25/2021
Last Update Date	:	01/25/2021

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