Healthcare Provider Details

I. General information

NPI: 1710495916
Provider Name (Legal Business Name): ALLIANCE ONCOLOGY OF ARIZONA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2018
Last Update Date: 01/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7340 E THOMAS RD
SCOTTSDALE AZ
85251-7216
US

IV. Provider business mailing address

18201 VON KARMAN AVE STE 600
IRVINE CA
92612-1176
US

V. Phone/Fax

Practice location:
  • Phone: 480-945-6896
  • Fax: 480-945-7287
Mailing address:
  • Phone: 949-242-5592
  • Fax: 602-773-3622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: RHONDA LONGMORE- GRUND
Title or Position: CFO
Credential:
Phone: 800-544-3215