MEDICARE: ARIZONA REGENERATIVE SOLUTIONS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207LP2900X	Pain Medicine (Anesthesiology) Physician
2	208VP0014X	Interventional Pain Medicine Physician
3	208VP0000X	Pain Medicine Physician

General Provider Information

NPI Number	:	1770241184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA REGENERATIVE SOLUTIONS

Provider Business Mailing Address
First Line	:	5310 W THUNDERBIRD RD STE 215
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85306-4712
Country	:	US
Telephone Number	:	602-242-9891
Fax Number	:	602-242-9895

Provider Business Practice Location Address
First Line	:	5310 W THUNDERBIRD RD STE 215
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85306-4712
Country	:	US
Telephone Number	:	602-242-9891
Fax Number	:	602-242-9895

Authorized Official
Title or Position	:	CEO
Name	:	MICHAEL CASTILLO
Credential	:	MD
Telephone Number	:	602-242-9891

Provider Enumeration Date	:	12/02/2021
Last Update Date	:	12/02/2021

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Directions to “ARIZONA REGENERATIVE SOLUTIONS ” Practice Location

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