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General NPI Number Information
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NPI Number | 1356445365
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Entity Type | Organization
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Legal Business Name | CIGNA HEALTH CARE OF ARIZONA INC.
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Dates
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Enumeration Date | 09/11/2006
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Last Update Date | 06/16/2023
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Provider Practice Location Address
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Address Line | 5891 W EUGIE AVE
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City | GLENDALE
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State | AZ
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Zip | 85304-1252
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Country | US
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Telephone | 602-588-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 8888 E RAINTREE DR FL 3
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3951
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Country | US
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Telephone | 602-328-8400
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL DIRECTOR
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Name | KEVIN ELLIS
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Credential | D.O.
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Telephone | 623-277-2246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | OTC 0624
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License Number State | AZ
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