MEDICARE: SAN TAN CARDIOVASCULAR CENTER LLC

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	207RC0000X	Cardiovascular Disease Physician	25431	AZ

General Provider Information

NPI Number	:	1548438716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAN TAN CARDIOVASCULAR CENTER LLC

Provider Business Mailing Address
First Line	:	6859 E REMBRANDT AVE
Second Line	:	SUIT 117
City	:	MESA
State	:	AZ
Zip	:	85212-3628
Country	:	US
Telephone Number	:	480-632-1577
Fax Number	:

Provider Business Practice Location Address
First Line	:	6859 E REMBRANDT AVE
Second Line	:	SUITE 117
City	:	MESA
State	:	AZ
Zip	:	85212-3628
Country	:	US
Telephone Number	:	480-390-3773
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ZELALEM YILMA
Credential	:	MD
Telephone Number	:	480-632-1577

Provider Enumeration Date	:	02/11/2008
Last Update Date	:	07/31/2025

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Practice Location Address:

6859 E REMBRANDT AVE , SUITE 117
MESA, AZ
85212-3628

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6859 E REMBRANDT AVE , SUITE 117
MESA, AZ
85212-3628

Practice Phone: 480-632-1577
Practice Fax: 480-632-1574

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Practice Location Address:

6859 E REMBRANDT AVE , SUITE 117
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85212-3628

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Practice Location Address:

6859 E REMBRANDT AVE , STE 117
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85212-3628

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1154777647 — INTEGRASURGICAL AMBULATORY CENTERS OF ARIZONA
Practice Location Address:

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Practice Fax:

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