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General NPI Number Information
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NPI Number | 1184165938
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Entity Type | Organization
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Legal Business Name | AZ MED LLC
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Dates
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Enumeration Date | 03/13/2017
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Last Update Date | 10/24/2017
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Provider Practice Location Address
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Address Line | 706 N MCQUEEN RD
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City | GILBERT
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State | AZ
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Zip | 85233-3500
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Country | US
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Telephone | 619-200-3233
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Fax |
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Provider Business Mailing Address
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Address Line | 706 N MCQUEEN RD STE 109
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City | GILBERT
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State | AZ
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Zip | 85233-3538
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Country | US
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Telephone | 480-405-9789
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | VICTORIA BARON
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Credential |
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Telephone | 310-767-6117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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