Healthcare Provider Details

I. General information

NPI: 1851005748
Provider Name (Legal Business Name): COMPREHENSIVE SURGICAL CENTER II, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2023
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2155 E CONFERENCE DR STE 111
TEMPE AZ
85284-2604
US

IV. Provider business mailing address

2155 E CONFERENCE DR STE 111
TEMPE AZ
85284-2604
US

V. Phone/Fax

Practice location:
  • Phone: 480-839-2020
  • Fax: 480-839-2121
Mailing address:
  • Phone: 480-839-2020
  • Fax: 480-839-2121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JASON BABCOCK
Title or Position: MANAGER
Credential:
Phone: 480-839-2020