Provider Demographics
NPI:1043461437
Name:ARIZONA CANCER SPECIALISTS PLC
Entity Type:Organization
Organization Name:ARIZONA CANCER SPECIALISTS PLC
Other - Org Name:ARIZONA BREAST CANCER SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CORAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:QUIET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-922-4600
Mailing Address - Street 1:PO BOX 3106
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90078-3106
Mailing Address - Country:US
Mailing Address - Phone:480-922-4600
Mailing Address - Fax:480-955-5231
Practice Address - Street 1:9055 E. DEL CAMINO
Practice Address - Street 2:SUITE 200
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258
Practice Address - Country:US
Practice Address - Phone:480-922-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-04
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ395133Medicaid
AZZ127576Medicare PIN