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General NPI Number Information
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NPI Number | 1619971470
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Entity Type | Organization
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Legal Business Name | ARIZONA ADVANCED SURGERY CENTER, LLC
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 04/10/2015
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Provider Practice Location Address
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Address Line | 9819 N 95TH ST 110
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4588
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Country | US
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Telephone | 480-874-2229
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Fax | 480-874-2231
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Provider Business Mailing Address
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Address Line | 9819 N 95TH ST 110
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4588
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Country | US
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Telephone | 480-874-2229
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Fax | 480-874-2231
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Authorized Official
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Title or Position | MANAGER/MEDICAL DIRECTOR
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Name | DR. NATHANIEL ZONERAICH
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Credential | M.D.
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Telephone | 480-874-2229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 33844
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License Number State | AZ
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