Organization
APRTC ANTHEM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS MOSHIRI MD (MANAGER)
(602) 441-3573
Entity
Organization
Contact information
Practice address
3624 W ANTHEM WAY STE C106, ANTHEM, AZ 85086-0454
(623) 688-5490
Mailing address
21001 N TATUM BLVD STE 1630-606, PHOENIX, AZ 85050-4242
(602) 354-5310
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
06/28/2019
Last updated
02/24/2022
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