Healthcare Provider Details

I. General information

NPI: 1245470798
Provider Name (Legal Business Name): DESERT SPRINGS CANCER CARE, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2009
Last Update Date: 03/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21803 N SCOTTSDALE RD SUITE 110
SCOTTSDALE AZ
85255-7444
US

IV. Provider business mailing address

21803 N SCOTTSDALE RD SUITE 110
SCOTTSDALE AZ
85255-7444
US

V. Phone/Fax

Practice location:
  • Phone: 480-585-4673
  • Fax: 480-585-4672
Mailing address:
  • Phone: 480-585-4673
  • Fax: 480-585-4672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number30123
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number35043
License Number StateAZ

VIII. Authorized Official

Name: DR. ANDREW J BURESH
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 480-585-4673