Organization
ARIZONA HEART DOCTOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL ALEJO (CREDENTIALING SPECIALIST)
(480) 739-2014
Entity
Organization
Contact information
Practice address
2045 S VINEYARD STE 119, MESA, AZ 85210-6889
(480) 300-4646
(480) 300-4647
Mailing address
PO BOX 32275, MESA, AZ 85275-2275
(480) 300-4646
(480) 300-4647
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
609549
—
AZ
Enumeration date
02/11/2013
Last updated
04/09/2021
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