Healthcare Provider Details

I. General information

NPI: 1043630221
Provider Name (Legal Business Name): ARIA SURGICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2014
Last Update Date: 04/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11784 N 131ST ST
SCOTTSDALE AZ
85259-3604
US

IV. Provider business mailing address

PO BOX 20610
MESA AZ
85277-0610
US

V. Phone/Fax

Practice location:
  • Phone: 480-406-7666
  • Fax: 480-985-0468
Mailing address:
  • Phone: 480-985-1093
  • Fax: 480-296-7643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4668
License Number StateAZ

VIII. Authorized Official

Name: TANJA LEA GUNSBERGER
Title or Position: MEMBER
Credential: DO
Phone: 480-406-7666