Organization
SAN TAN CARDIOVASCULAR CENTER, LLC
Active
Organization
SAN TAN CARDIOVASCULAR CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOTTIE RANKIN (OFFICE SUPERVISOR)
(480) 632-1577
Entity
Organization
Contact information
Practice address
6740 S KINGS RANCH RD, SUITE 103, GOLD CANYON, AZ 85118-2925
(480) 543-1525
Mailing address
6859 E REMBRANDT AVE, SUITE 117, MESA, AZ 85212-3628
(480) 632-1577
(480) 632-1574
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
49056
AZ
207RC0000X
Cardiovascular Disease Physician
25431
AZ
207RI0200X
Infectious Disease Physician
40956
AZ
363AM0700X
Medical Physician Assistant
3560
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528020377
NPI
AZ
01
—
1548438716
NPI
AZ
Enumeration date
03/23/2010
Last updated
05/07/2010
Update your record
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