Healthcare Provider Details

I. General information

NPI: 1124580691
Provider Name (Legal Business Name): QUALITY TIME ANESTHESIA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2019
Last Update Date: 08/28/2020
Certification Date: 08/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S DOBSON RD
MESA AZ
85202-4707
US

IV. Provider business mailing address

661 W VIA DE PALMAS
SAN TAN VALLEY AZ
85140-7381
US

V. Phone/Fax

Practice location:
  • Phone: 480-412-3000
  • Fax:
Mailing address:
  • Phone: 480-292-3113
  • Fax: 480-454-8228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. RACHEL CHRISTINE PETERS
Title or Position: ADMINISTRATOR
Credential: RN, BSN
Phone: 480-292-3113