Healthcare Provider Details
I. General information
NPI: 1659487833
Provider Name (Legal Business Name): CENTRAL ARIZONA MEDICAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/21/2006
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3638 E SOUTHERN AVE STE C 108
MESA AZ
85206-2563
US
IV. Provider business mailing address
3638 E SOUTHERN AVE STE C 108
MESA AZ
85206-2563
US
V. Phone/Fax
- Phone: 480-834-0771
- Fax: 480-834-1136
- Phone: 480-834-0771
- Fax: 480-834-1136
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
ERANA
K
CROSSMAN
Title or Position: BILLING MANAGER
Credential: CPC
Phone: 480-834-0771