Organization
TAACH PATHOLOGY, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY DAVID KHACHATURIAN (BUSINESS MANAGER)
(480) 922-4923
Entity
Organization
Contact information
Practice address
15612 N 32ND ST, STE. #3, PHOENIX, AZ 85032-3859
(602) 251-8052
(602) 251-8068
Mailing address
6501 E. GREENWAY PKWY., #103-447, SCOTTSDALE, AZ 85254
(480) 922-4923
(480) 922-4924
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
03D1074399 CLIA
AZ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
13453 STATE LICENSE
AZ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432137
—
AZ
Enumeration date
03/16/2006
Last updated
11/03/2016
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