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General NPI Number Information
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NPI Number | 1912589656
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE SURGICAL CARE, LLC
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Dates
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Enumeration Date | 04/22/2021
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Last Update Date | 04/22/2021
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Provider Practice Location Address
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Address Line | 8752 E VIA DE COMMERCIO STE 2
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-3396
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Country | US
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Telephone | 602-772-2382
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Fax |
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Provider Business Mailing Address
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Address Line | 2990 E NORTHERN AVE STE C103
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City | PHOENIX
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State | AZ
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Zip | 85028-4839
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Country | US
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Telephone | 602-772-2382
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARCO VALERIO CANULLA X
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Credential | MD
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Telephone | 602-571-6521
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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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