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General NPI Number Information
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NPI Number | 1962470971
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Entity Type | Organization
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Legal Business Name | THE HEART CLINIC PC
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 01/08/2015
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Provider Practice Location Address
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Address Line | 10293 N 92ND ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4565
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Country | US
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Telephone | 480-747-6535
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Fax | 480-747-6538
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Provider Business Mailing Address
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Address Line | 10293 N 92ND ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4565
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Country | US
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Telephone | 480-747-6535
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Fax | 480-747-6538
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Authorized Official
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Title or Position | MD
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Name | DR. IMAD H KHALED
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Credential | MD
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Telephone | 480-747-6535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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