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General NPI Number Information
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NPI Number | 1285767822
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Entity Type | Organization
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Legal Business Name | ARIZONA SURGICAL SPECIALISTS CENTER, LLC
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 02/02/2019
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Provider Practice Location Address
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Address Line | 1984 E BASELINE RD
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City | TEMPE
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State | AZ
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Zip | 85283-1535
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Country | US
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Telephone | 480-237-1234
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Fax | 480-237-1236
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Provider Business Mailing Address
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Address Line | 5281 N 99TH AVE SUITE 100
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City | GLENDALE
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State | AZ
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Zip | 85305-3105
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Country | US
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Telephone | 480-237-1234
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Fax | 623-691-8502
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN SIWEK
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Credential | MD
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Telephone | 623-516-8252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | OSC6456
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License Number State | AZ
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