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Organization

TOCA AT BANNER HEALTH LLC

Active
Parent organization
BANNER MEDICAL GROUP
Organization subpart
Yes

Provider details

NPI number
Legal business name
BANNER MEDICAL GROUP
Authorized official
SHIVA BIRDI (CEO)
(602) 747-4000
Entity
Organization

Contact information

Practice address
18700 N 64TH DR STE 205, GLENDALE, AZ 85308-7112
(602) 536-7480
(602) 533-4167
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
208100000X
Physical Medicine & Rehabilitation Physician

Other

Enumeration date
03/16/2020
Last updated
04/16/2026
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