Organization
COASTERRA ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCINDA MATTALINO (MANAGER)
(602) 429-0404
Entity
Organization
Contact information
Practice address
3219 E CAMELBACK RD STE 272, PHOENIX, AZ 85018-2307
(602) 429-0404
Mailing address
2801 CENTERVILLE ROAD, PMB 655, WILMINGTON, DE 19808
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
10/19/2017
Last updated
10/19/2017
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