Healthcare Provider Details

I. General information

NPI: 1457503740
Provider Name (Legal Business Name): CRISTINA CHALK RIZK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CRISTINA MIRANDA CHALK

II. Dates (important events)

Enumeration Date: 10/17/2008
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8108 E GARY RD
SCOTTSDALE AZ
85260-6516
US

IV. Provider business mailing address

8108 E GARY RD
SCOTTSDALE AZ
85260-6516
US

V. Phone/Fax

Practice location:
  • Phone: 843-338-6294
  • Fax:
Mailing address:
  • Phone: 843-338-6294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number8747
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number1347
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: