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General NPI Number Information
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NPI Number | 1528526472
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Entity Type | Organization
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Legal Business Name | CITY OF HOPE MEDICAL GROUP OF ARIZONA LLC
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Dates
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Enumeration Date | 03/11/2019
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 3530 S VAL VISTA DR STE C203
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City | GILBERT
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State | AZ
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Zip | 85297-7318
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Country | US
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Telephone | 480-530-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 6897 PAYSPHERE CIRCLE
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City | CHICAGO
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State | IL
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Zip | 60674-6897
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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 | DIRECTOR, CREDENTIALING
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Name | HEIDI BETH CARMEAN
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Credential |
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Telephone | 909-803-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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