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General NPI Number Information
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NPI Number | 1346704210
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Entity Type | Organization
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Legal Business Name | CONCIERGE ANESTHESIA SERVICES, PLLC
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Dates
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Enumeration Date | 01/24/2019
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Last Update Date | 01/24/2019
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Provider Practice Location Address
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Address Line | 8405 E VISTA CANYON CIR
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City | MESA
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State | AZ
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Zip | 85207-1469
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Country | US
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Telephone | 602-418-6687
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Fax |
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Provider Business Mailing Address
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Address Line | 8405 E VISTA CANYON CIR
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City | MESA
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State | AZ
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Zip | 85207-1469
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GREG WONG
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Credential | MD
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Telephone | 602-418-6687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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