Healthcare Provider Details

I. General information

NPI: 1780828707
Provider Name (Legal Business Name): SAGUARO PHYSICIANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2009
Last Update Date: 04/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N EL DORADO PL SUITE 670
TUCSON AZ
85715-4637
US

IV. Provider business mailing address

PO BOX 29211
PHOENIX AZ
85038-9211
US

V. Phone/Fax

Practice location:
  • Phone: 520-324-3774
  • Fax:
Mailing address:
  • Phone: 602-273-6770
  • Fax: 602-889-0483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT J. BERENS
Title or Position: MEMBER
Credential: M.D.
Phone: 800-477-6770