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General NPI Number Information
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NPI Number | 1831560176
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Entity Type | Organization
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Legal Business Name | CAMELBACK ANESTHESIA PLLC
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Dates
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Enumeration Date | 10/13/2015
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Last Update Date | 11/04/2015
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Provider Practice Location Address
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Address Line | 2421 E SOUTHERN AVE STE 1
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City | TEMPE
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State | AZ
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Zip | 85282-7612
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Country | US
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Telephone | 480-425-2160
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Fax | 480-351-8797
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Provider Business Mailing Address
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Address Line | 2421 E SOUTHERN AVE STE 1
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City | TEMPE
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State | AZ
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Zip | 85282-7612
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Country | US
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Telephone | 480-425-2160
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Fax | 480-351-8797
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. GREGG MARTIN CITRON
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Credential | MD
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Telephone | 480-425-2160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 19985
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License Number State | AZ
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