Healthcare Provider Details

I. General information

NPI: 1356865141
Provider Name (Legal Business Name): PALILLA ANESTHESIA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2017
Last Update Date: 08/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 E MCDOWELL RD
PHOENIX AZ
85006-2622
US

IV. Provider business mailing address

7878 N 16TH ST STE 250
PHOENIX AZ
85020-4478
US

V. Phone/Fax

Practice location:
  • Phone: 602-258-1521
  • Fax:
Mailing address:
  • Phone: 602-395-0718
  • Fax: 602-277-8146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: THOMAS F PALILLA
Title or Position: PRESIDENT
Credential: MD
Phone: 602-395-0718