Healthcare Provider Details
I. General information
NPI: 1205086378
Provider Name (Legal Business Name): DESERT SPRINGS CANCER CARE, P.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/25/2008
Last Update Date: 09/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8950 S 52ND ST SUITE 101
TEMPE AZ
85284-1046
US
IV. Provider business mailing address
8950 S 52ND ST SUITE 101
TEMPE AZ
85284-1046
US
V. Phone/Fax
- Phone: 602-441-9520
- Fax:
- Phone: 602-441-9520
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 30123 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 35043 |
| License Number State | AZ |
VIII. Authorized Official
Name:
LESLIE
A
MENG
Title or Position: PARTNER
Credential: M.D.
Phone: 602-441-9520