Healthcare Provider Details
I. General information
NPI: 1255655486
Provider Name (Legal Business Name): ARIZONA CENTER FOR HEMATOLOGY AND ONCOLOGY, PLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/17/2010
Last Update Date: 04/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14674 W MOUNTAIN VIEW BLVD SUITE 105
SURPRISE AZ
85374-2706
US
IV. Provider business mailing address
5750 W THUNDERBIRD RD C300
GLENDALE AZ
85306-4660
US
V. Phone/Fax
- Phone: 602-938-2848
- Fax: 602-938-4401
- Phone: 602-938-2848
- Fax: 602-938-4401
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 20589 |
| License Number State | AZ |
VIII. Authorized Official
Name:
DEVINDER
SINGH
Title or Position: PRESIDENT
Credential: MD
Phone: 602-938-2848