Healthcare Provider Details

I. General information

NPI: 1689110314
Provider Name (Legal Business Name): TRUSTED CARE SURGERY CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2017
Last Update Date: 01/31/2020
Certification Date: 01/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20950 N TATUM BLVD SUITE 170
PHOENIX AZ
85050-4200
US

IV. Provider business mailing address

20950 N TATUM BLVD STE 170
PHOENIX AZ
85050-4272
US

V. Phone/Fax

Practice location:
  • Phone: 602-715-1654
  • Fax: 480-800-8507
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WAYNE DESTEFANO
Title or Position: OWNER
Credential:
Phone: 602-595-5027