MEDICARE: DESERT HEART CENTER LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1225089014
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESERT HEART CENTER LTD

Provider Business Mailing Address
First Line	:	3815 E BELL ROAD
Second Line	:	SUITE # 3400
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2159
Country	:	US
Telephone Number	:	602-971-2761
Fax Number	:	602-917-1529

Provider Business Practice Location Address
First Line	:	3815 E BELL ROAD
Second Line	:	SUITE # 3400
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2159
Country	:	US
Telephone Number	:	602-971-2761
Fax Number	:	602-917-1529

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	LYDIA GALLEGOS
Credential	:
Telephone Number	:	602-931-4530

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	07/27/2007

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Directions to “DESERT HEART CENTER LTD ” Practice Location

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