Healthcare Provider Details
I. General information
NPI: 1447925698
Provider Name (Legal Business Name): MG PLASTIC SURGERY P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/10/2021
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20201 N SCOTTSDALE HEALTHCARE DR STE 120
SCOTTSDALE AZ
85255-4135
US
IV. Provider business mailing address
20201 N SCOTTSDALE HEALTHCARE DR STE 120
SCOTTSDALE AZ
85255-4135
US
V. Phone/Fax
- Phone: 480-805-3052
- Fax: 480-805-2582
- Phone: 480-805-3052
- Fax: 480-805-2582
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0122X |
| Taxonomy | Plastic and Reconstructive Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MANUEL
GIGENA
Title or Position: PLASTIC SURGEON
Credential: MD
Phone: 503-883-3954