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General NPI Number Information
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NPI Number | 1568803047
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE INTERVENTIONAL CARE CENTERS, PLLC
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Dates
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Enumeration Date | 07/11/2013
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 838 W ELLIOT RD # 101
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City | GILBERT
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State | AZ
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Zip | 85233-5162
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Country | US
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Telephone | 480-374-7354
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Fax | 480-371-1121
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Provider Business Mailing Address
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Address Line | 838 W ELLIOT RD # 101
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City | GILBERT
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State | AZ
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Zip | 85233-5162
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Country | US
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Telephone | 480-374-7354
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Fax | 480-371-1121
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOEL R RAINWATER
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Credential | M.D.
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Telephone | 480-374-7354
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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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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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