Organization
ORTANSA, PC
Active
Organization
ORTANSA, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRELA E. PONDUCHI MD (PRESIDENT)
(312) 218-6820
Entity
Organization
Contact information
Practice address
1800 E VAN BUREN ST., PHOENIX, AZ 85006-3742
(602) 251-8316
(480) 333-5165
Mailing address
21001 N TATUM BLVD, STE 1630-463, PHOENIX, AZ 85050-4206
(312) 218-6820
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
42568
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
743215
—
AZ
Enumeration date
09/23/2012
Last updated
03/30/2018
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