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General NPI Number Information
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NPI Number | 1891572517
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Entity Type | Organization
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Legal Business Name | PEAK CARDIOVASCULAR CENTER LLC
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Dates
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Enumeration Date | 09/14/2023
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 12361 W BOLA DR STE 112
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City | SURPRISE
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State | AZ
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Zip | 85378-9021
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Country | US
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Telephone | 623-200-5397
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Fax |
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Provider Business Mailing Address
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Address Line | 12361 W BOLA DR STE 112
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City | SURPRISE
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State | AZ
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Zip | 85378-9021
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Country | US
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Telephone | 623-200-5397
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | STEPHEN SMITH
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Credential | MD
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Telephone | 623-200-5397
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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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