Organization
IRC DC AZ, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARVIND DURVASAN (OWNER)
(623) 240-1110
Entity
Organization
Contact information
Practice address
14780 W MOUNTAIN VIEW BLVD STE 109, SURPRISE, AZ 85374-7280
(623) 240-1110
Mailing address
14780 W MOUNTAIN VIEW BLVD STE 109, SURPRISE, AZ 85374-7280
(623) 240-1110
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
830265
—
AZ
Enumeration date
03/11/2020
Last updated
03/11/2020
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