Healthcare Provider Details

I. General information

NPI: 1871735001
Provider Name (Legal Business Name): DESERT CARDIOVASCULAR SURGEONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2009
Last Update Date: 08/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21579 N 56TH AVE
GLENDALE AZ
85308-6287
US

IV. Provider business mailing address

21579 N 56TH AVE
GLENDALE AZ
85308-6287
US

V. Phone/Fax

Practice location:
  • Phone: 610-737-4445
  • Fax: 623-266-3889
Mailing address:
  • Phone: 610-737-4445
  • Fax: 623-266-3889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number3749
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number3749
License Number StateAZ

VIII. Authorized Official

Name: DR. JEFFREY ALPERN
Title or Position: OWNER/PHYSICIAN
Credential: D.O.
Phone: 610-737-4445