Provider Demographics
NPI:1043278377
Name:AZTECH RADIOLOGY AND OPEN MRI
Entity Type:Organization
Organization Name:AZTECH RADIOLOGY AND OPEN MRI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN-CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAKESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PAHWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-706-1096
Mailing Address - Street 1:2653 W GUADALUPE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-7200
Mailing Address - Country:US
Mailing Address - Phone:480-889-3500
Mailing Address - Fax:480-889-3502
Practice Address - Street 1:4530 E RAY RD
Practice Address - Street 2:SUITE 160
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-6094
Practice Address - Country:US
Practice Address - Phone:480-893-1004
Practice Address - Fax:480-893-0306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0830070OtherBLUE CROSS BLUE SHIELD GR
AZ431221Medicaid
AZ470001313OtherRAILROAD MEDICARE
AZ431221Medicaid