Healthcare Provider Details

I. General information

NPI: 1750768099
Provider Name (Legal Business Name): ATLAS ANESTHESIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2015
Last Update Date: 07/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 E THOMAS RD
PHOENIX AZ
85016-7711
US

IV. Provider business mailing address

8424 E SHEA BLVD #101
SCOTTSDALE AZ
85260-6662
US

V. Phone/Fax

Practice location:
  • Phone: 480-256-1518
  • Fax: 480-478-6628
Mailing address:
  • Phone: 480-256-1518
  • Fax: 480-478-6628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number34938
License Number StateAZ

VIII. Authorized Official

Name: DR. RICARDO VERDINER
Title or Position: OWNER
Credential: M.D.
Phone: 480-256-1518