Healthcare Provider Details

I. General information

NPI: 1295613479
Provider Name (Legal Business Name): PINNACLE ANESTHESIA PARTNERS ARIZONA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3652 E MAFFEO RD
PHOENIX AZ
85050-8339
US

IV. Provider business mailing address

PO BOX 7096
STOCKTON CA
95267-0096
US

V. Phone/Fax

Practice location:
  • Phone: 480-767-2100
  • Fax:
Mailing address:
  • Phone: 480-772-5988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KIM LE
Title or Position: PARTNER
Credential: CRNA
Phone: 480-772-5988