Healthcare Provider Details

I. General information

NPI: 1316604911
Provider Name (Legal Business Name): CACTUS ANESTHESIA PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2021
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 S HIGLEY RD STE 102
GILBERT AZ
85296-4798
US

IV. Provider business mailing address

1425 S HIGLEY RD STE 102
GILBERT AZ
85296-4798
US

V. Phone/Fax

Practice location:
  • Phone: 800-959-5509
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: RYAN GIBB
Title or Position: GENERAL PARTNER
Credential: MD
Phone: 800-959-5509