Healthcare Provider Details

I. General information

NPI: 1770535742
Provider Name (Legal Business Name): ERIKA L VATSAR FAIL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 E DOBSON ROAD
MESA AZ
85202-4707
US

IV. Provider business mailing address

12329 N 89TH PL
SCOTTSDALE AZ
85260-5061
US

V. Phone/Fax

Practice location:
  • Phone: 480-276-1598
  • Fax: 480-275-4495
Mailing address:
  • Phone: 602-509-3234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number30554
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: