Organization
AVANTGARDE CARDIOVASCULAR SERVICES PC
Active
Parent organization
AVANTGARDE CARDIOVASCULAR SERVICES PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AVANTGARDE CARDIOVASCULAR SERVICES PC
Authorized official
PEGGY JETER (OFFICE MANAGER)
(623) 583-2073
Entity
Organization
Contact information
Practice address
11124 W CALIFORNIA AVE, SUITE G, YOUNGTOWN, AZ 85363-1246
(623) 583-2073
Mailing address
11124 W CALIFORNIA AVE, SUITE G, YOUNGTOWN, AZ 85363-1246
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
097588
—
AZ
Enumeration date
01/31/2023
Last updated
01/31/2023
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