Provider Demographics
NPI:1043617368
Name:AZ TECH RADIOLOGY AND OPEN MRI LLC
Entity Type:Organization
Organization Name:AZ TECH RADIOLOGY AND OPEN MRI LLC
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 1:22873 LA CORNICHE WAY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-6013
Practice Address - Country:US
Practice Address - Phone:217-553-1016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-02
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty