# DESERT RIDGE OUTPATIENT SURGERY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992713176
- **Authorized official:** ERIC BOON (OFFICER / AUTHORIZED OFFICIAL)
- **Authorized official phone:** (480) 567-0269

## Contact information

- **Practice address:** 20940 N TATUM BLVD, STE 100, PHOENIX, AZ 85050
- **Practice address phone:** (480) 502-4000
- **Practice address fax:** (480) 502-4050
- **Mailing address:** 20940 N TATUM BLVD, STE 100, PHOENIX, AZ 85050-4265
- **Mailing address phone:** (480) 502-4000
- **Mailing address fax:** (480) 502-4050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | OSC4133 | AZ | Yes |

## Other

- **Enumeration date:** 08/04/2006
- **Last updated:** 09/19/2024