Healthcare Provider Details
I. General information
NPI: 1679508105
Provider Name (Legal Business Name): CORNERSTONE WOMENS CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/12/2006
Last Update Date: 02/03/2021
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9377 E BELL RD STE 143
SCOTTSDALE AZ
85260-1503
US
IV. Provider business mailing address
9377 E BELL RD STE 143
SCOTTSDALE AZ
85260-1503
US
V. Phone/Fax
- Phone: 602-867-2690
- Fax: 602-404-1904
- Phone: 602-867-2690
- Fax: 602-404-1904
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VICKI
JANZEN
Title or Position: OFFICE MANAGER
Credential:
Phone: 602-867-2690