Healthcare Provider Details
I. General information
NPI: 1700130804
Provider Name (Legal Business Name): ARIZONA CENTER FOR HEMATOLOGY AND ONCOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/29/2012
Last Update Date: 01/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10250 N 92ND ST 118
SCOTTSDALE AZ
85258-4510
US
IV. Provider business mailing address
5750 W THUNDERBIRD RD C300
GLENDALE AZ
85306-4660
US
V. Phone/Fax
- Phone: 480-860-6486
- Fax: 480-860-0896
- Phone: 602-938-2848
- Fax: 602-938-4401
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208800000X |
| Taxonomy | Urology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DEVINDER
SINGH
Title or Position: PRESIDENT
Credential: MD
Phone: 602-938-2848