=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275670408
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ATEN CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2007
-----------------------------------------------------
Last Update Date | 04/09/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3337 N MILLER RD STE. 102
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85251-6495
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-990-1280
-----------------------------------------------------
Fax | 480-990-1410
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3337 N MILLER RD STE. 102
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85251-6495
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-990-1280
-----------------------------------------------------
Fax | 480-990-1410
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT & MEDICAL DIRECTOR
-----------------------------------------------------
Name | DR. ANGELO CHIRBAN
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 480-990-1280
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208VP0000X
-----------------------------------------------------
Taxonomy Name | Pain Medicine Physician
-----------------------------------------------------
License Number | 27055
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------