Healthcare Provider Details

I. General information

NPI: 1518853928
Provider Name (Legal Business Name): EAST VALLEY RADIOLOGY ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1955 W FRYE RD
CHANDLER AZ
85224-6282
US

IV. Provider business mailing address

3800 N CENTRAL AVE
PHOENIX AZ
85012-1992
US

V. Phone/Fax

Practice location:
  • Phone: 480-728-3000
  • Fax:
Mailing address:
  • Phone: 480-718-1098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARC TOBLER
Title or Position: OWNER
Credential:
Phone: 480-718-1098