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NPI Code Detail

MEDICARE: ILANA DORIS-RUTH WEST M.D.

MEDICARE: ILANA DORIS-RUTH WEST M.D.
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 Physician33656AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AZ0770430OTHERAZBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861498487
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILANA DORIS-RUTH WEST M.D.
Provider Business Mailing Address
First Line : 16601 N 40TH ST STE 204
Second Line :
City : PHOENIX
State : AZ
Zip : 85032-3356
Country : US
Telephone Number : 602-996-4747
Fax Number : 602-953-5466
Provider Business Practice Location Address
First Line : 16601 N 40TH ST STE 204
Second Line :
City : PHOENIX
State : AZ
Zip : 85032-3356
Country : US
Telephone Number : 602-996-4747
Fax Number : 602-953-5466
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 07/21/2022

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Directions to “ ILANA DORIS-RUTH WEST M.D.” Practice Location

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