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Organization

CASELLI AVENUE PROFESSIONALS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN SUTHERLAND M.D. (CEO)
(602) 714-6783
Entity
Organization

Contact information

Practice address
9812 N 7TH ST, 9812 N. 7TH STREET, PHOENIX, AZ 85020-1763
(602) 714-6783
(602) 325-0125
Mailing address
9812 N 7TH ST, 9812 N7TH STREET SUITE 7, PHOENIX, AZ 85020-1763
(602) 714-6783
(602) 325-0125

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
27081
AZ
207RB0002X
Obesity Medicine (Internal Medicine) Physician
27081
AZ
207RC0000X
Cardiovascular Disease Physician
27081
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
445470
AZ
01
WCSKQ
SUN HEALTH GROUP
AZ
Enumeration date
11/02/2015
Last updated
11/02/2015
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