Healthcare Provider Details

I. General information

NPI: 1174949754
Provider Name (Legal Business Name): CHAN HEART RHYTHM INSTITUTE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2014
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6709 E SOUTHERN AVE STE 100
MESA AZ
85206-3738
US

IV. Provider business mailing address

6709 E SOUTHERN AVE STE 100
MESA AZ
85206-3738
US

V. Phone/Fax

Practice location:
  • Phone: 480-773-2220
  • Fax: 480-452-0533
Mailing address:
  • Phone: 480-773-2220
  • Fax: 480-452-0533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: RODRIGO C CHAN
Title or Position: MEMBER
Credential: MD
Phone: 480-773-2220