Organization
CENTRAL ARIZONA ENDOSCOPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE BORROR (ADMINISTRATOR)
(480) 751-3002
Entity
Organization
Contact information
Practice address
2158 N GILBERT RD, BUILDING 1 SUITE 103, MESA, AZ 85203-2112
(480) 751-3002
(480) 751-3003
Mailing address
2158 N GILBERT RD STE 103, MESA, AZ 85203-2109
(408) 751-3002
(408) 751-3003
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
OSC 4093
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03D1057109
CLIA WAIVER
—
05
—
217237
—
AZ
01
—
74203
AAAHC
—
01
—
OSC 4093
ARIZONA LICENSE
AZ
Enumeration date
07/05/2006
Last updated
11/04/2025
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