Healthcare Provider Details

I. General information

NPI: 1588109573
Provider Name (Legal Business Name): EXECUTIVE CARDIAC ARRHYTHMIA SOLUTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2016
Last Update Date: 05/20/2022
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4550 E BELL RD STE 130
PHOENIX AZ
85032-9306
US

IV. Provider business mailing address

4550 E BELL RD STE 130
PHOENIX AZ
85032-9306
US

V. Phone/Fax

Practice location:
  • Phone: 480-634-4449
  • Fax: 480-304-3525
Mailing address:
  • Phone: 480-634-4449
  • Fax: 480-304-3525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number48351
License Number StateAZ

VIII. Authorized Official

Name: DR. JOHN F BESHAI
Title or Position: PRESIDENT
Credential: MD
Phone: 480-634-4449