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, BANNER MEDICAL GROUP)
(480) 256-3336
Entity
Organization
Contact information
Practice address
9377 E BELL RD STE 231, SCOTTSDALE, AZ 85260-1503
(602) 533-4167
(602) 277-6211
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/30/2020
Last updated
07/26/2023
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