Healthcare Provider Details

I. General information

NPI: 1396703690
Provider Name (Legal Business Name): AZTECH RADIOLOGY AND OPEN MRI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 04/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 W APACHE TRL
APACHE JUNCTION AZ
85220-3728
US

IV. Provider business mailing address

2653 W GUADALUPE RD SUITE 201
MESA AZ
85202-7200
US

V. Phone/Fax

Practice location:
  • Phone: 480-288-6400
  • Fax: 480-889-3501
Mailing address:
  • Phone: 480-889-3500
  • Fax: 480-889-3502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. RAKESH PAHWA
Title or Position: CHAIRMAN CEO
Credential:
Phone: 480-706-1096