MEDICARE: ARIZONA CARDIAC SONOGRAPHERS 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	246XS1301X	Sonography Specialist/Technologist Cardiovascular	22125	AZ

General Provider Information

NPI Number	:	1477879625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA CARDIAC SONOGRAPHERS LLC

Provider Business Mailing Address
First Line	:	1801 E SHEENA DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-4533
Country	:	US
Telephone Number	:	602-368-6924
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 E SHEENA DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-4533
Country	:	US
Telephone Number	:	602-368-6924
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID D KAHLSTORF
Credential	:	ARDMS
Telephone Number	:	602-368-6924

Provider Enumeration Date	:	04/13/2010
Last Update Date	:	04/13/2010

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