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General NPI Number Information
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NPI Number | 1104027754
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Entity Type | Organization
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Legal Business Name | GASTROINTESTINAL & LIVER DISEASE CENTER PLLC
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 12/19/2007
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Provider Practice Location Address
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Address Line | 9305 W THOMAS RD SUITE #255
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City | PHOENIX
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State | AZ
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Zip | 85037-3328
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Country | US
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Telephone | 480-734-8737
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Fax |
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Provider Business Mailing Address
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Address Line | 9305 W THOMAS RD SUITE #225
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City | PHOENIX
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State | AZ
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Zip | 85037-3328
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Country | US
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Telephone | 623-236-8507
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Fax |
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Authorized Official
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Title or Position | OWNER & PHYSICIAN
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Name | DR. HECTOR IVAN RODRIGUEZ-LUNA
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Credential | MD
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Telephone | 480-734-8737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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