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General NPI Number Information
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NPI Number | 1851567291
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Entity Type | Organization
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Legal Business Name | KHATALI AMBULATORY SURGERY CENTER, LLC
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | 10450 E RIGGS RD SUITE 101
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City | SUN LAKES
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State | AZ
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Zip | 85248-7758
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Country | US
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Telephone | 480-636-5634
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Fax |
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Provider Business Mailing Address
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Address Line | 10450 E RIGGS RD STE 101
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City | SUN LAKES
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State | AZ
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Zip | 85248-7759
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Country | US
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Telephone | 414-258-9511
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Fax | 414-607-3948
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. DAVID N CALKINS
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Credential | M.D.
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Telephone | 480-636-5634
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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 |
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License Number State |
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