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General NPI Number Information
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NPI Number | 1194983296
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Entity Type | Organization
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Legal Business Name | EFREN CASANOVA MD, PC
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 05/27/2008
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Provider Practice Location Address
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Address Line | 8711 E PINNACLE PEAK RD PMB #203
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-3517
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Country | US
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Telephone | 602-347-6620
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Fax | 602-569-8308
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Provider Business Mailing Address
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Address Line | 8711 E PINNACLE PEAK RD PMB #203
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-3517
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Country | US
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Telephone | 602-347-6620
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Fax | 602-569-8308
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. BECKY L MORAN
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Credential |
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Telephone | 602-347-6620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 29488
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License Number State | AZ
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