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General NPI Number Information
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NPI Number | 1477335826
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Entity Type | Organization
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Legal Business Name | CARDIAC CARE ALLIANCE NETWORK OF ARIZONA LLC
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Dates
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Enumeration Date | 10/19/2023
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Last Update Date | 10/19/2023
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Provider Practice Location Address
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Address Line | 6223 E VIA ESTRELLA AVE
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City | PARADISE VALLEY
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State | AZ
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Zip | 85253-1254
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Country | US
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Telephone | 917-364-6662
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6299
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City | PEORIA
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State | AZ
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Zip | 85385-6299
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Country | US
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Telephone | 917-364-6662
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KISHLAY ANAND
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Credential | MD
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Telephone | 917-364-6662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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