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NPI Code Detail

MEDICARE: ARIZONA ADVANCED SURGERY LLC

MEDICARE: ARIZONA ADVANCED SURGERY 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
1208600000XSurgery Physician

General Provider Information

NPI Number : 1346880838
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARIZONA ADVANCED SURGERY LLC
Provider Business Mailing Address
First Line : 2320 N 3RD ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-1303
Country : US
Telephone Number : 602-649-2007
Fax Number : 602-258-9904
Provider Business Practice Location Address
First Line : 2320 N 3RD ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-1303
Country : US
Telephone Number : 602-258-9900
Fax Number : 602-258-9904
Authorized Official
Title or Position : MANAGING MEMBER
Name : CHARLES E CASTILLO
Credential : MD
Telephone Number : 602-258-9900
Provider Enumeration Date : 01/13/2020
Last Update Date : 07/15/2024

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Directions to “ARIZONA ADVANCED SURGERY LLC ” Practice Location

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