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Organization
NORTHERN ARIZONA ONCOLOGY CENTERS LLC
Active
Organization
NORTHERN ARIZONA ONCOLOGY CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK SHALVARJIAN (SENIOR VICE PRESIDENT)
(310) 335-4000
Entity
Organization
Contact information
Practice address
1100 GAIL GARDNER WAY, PRESCOTT, AZ 86305-1690
(928) 776-1040
(928) 776-1041
Mailing address
PO BOX 60990, LOS ANGELES, CA 90060-0990
(310) 335-4000
(310) 335-4098
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
—
NULL
207RX0202X
Medical Oncology Physician
—
—
2085R0001X
Radiation Oncology Physician
—
NULL
2085R0001X
Radiation Oncology Physician
—
—
261QX0203X
Radiation Oncology Clinic/Center
Primary
—
NULL
Other
Enumeration date
07/20/2010
Last updated
04/09/2012
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