Individual
DR. KOMANDOOR SRIVATHSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
24301
AZ
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
24301
AZ
Other
Enumeration date
11/23/2005
Last updated
09/10/2020
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