Healthcare Provider Details

I. General information

NPI: 1831818459
Provider Name (Legal Business Name): HONORHEALTH AMBULATORY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 08/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18404 N TATUM BLVD STE 101C
PHOENIX AZ
85032-1511
US

IV. Provider business mailing address

PO BOX 845635
LOS ANGELES CA
90084-5635
US

V. Phone/Fax

Practice location:
  • Phone: 623-683-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: PIXIE ZAGARRIGO
Title or Position: NTWK DIRECTOR OF REVENUE CYCLE
Credential:
Phone: 623-434-6200