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General NPI Number Information
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NPI Number | 1730746843
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Entity Type | Organization
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Legal Business Name | ARIZONA ADVANCED SURGICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 05/23/2019
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Last Update Date | 09/10/2022
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Provider Practice Location Address
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Address Line | 120 W CALLE DE LAS TIENDAS
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-4326
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Country | US
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Telephone | 520-990-9960
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Fax | 520-686-7636
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Provider Business Mailing Address
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Address Line | 1160 S CASTAR DR
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City | TUCSON
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State | AZ
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Zip | 85745-4505
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Country | US
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Telephone | 520-358-4087
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Fax | 520-686-7636
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Authorized Official
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Title or Position | MD/OWNER
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Name | VINOD GOLLAPALLI
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Credential | MD
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Telephone | 520-393-4937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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