Healthcare Provider Details

I. General information

NPI: 1861700957
Provider Name (Legal Business Name): CARDINAL ANESTHESIA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2010
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5448 HIGHWAY 260
LAKESIDE AZ
85929-5739
US

IV. Provider business mailing address

PO BOX 5870
MESA AZ
85211-5870
US

V. Phone/Fax

Practice location:
  • Phone: 928-358-1862
  • Fax: 928-537-2049
Mailing address:
  • Phone: 480-874-7014
  • Fax: 480-874-7015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCRNA0679
License Number StateAZ

VIII. Authorized Official

Name: FRANK FREUND
Title or Position: MANAGING PARTNER
Credential: CRNA
Phone: 612-220-7671