=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609887959
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANAND VENKATESH NARAYANAPPA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/11/2006
-----------------------------------------------------
Last Update Date | 05/28/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1850 N CENTRAL AVE SUITE1600
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85004-4633
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-744-4765
-----------------------------------------------------
Fax | 602-744-4799
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 645 E MISSOURI AVE STE 300
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85012-1351
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-262-8900
-----------------------------------------------------
Fax | 602-262-8890
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | 35070
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------