Provider Demographics
NPI:1104015734
Name:SIROUNIAN ORTHOPEDICS PC
Entity Type:Organization
Organization Name:SIROUNIAN ORTHOPEDICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIROUNIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:602-264-7273
Mailing Address - Street 1:10645 N TATUM BLVD STE 200
Mailing Address - Street 2:PMB 621
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3068
Mailing Address - Country:US
Mailing Address - Phone:602-264-7273
Mailing Address - Fax:602-264-7294
Practice Address - Street 1:9250 N 3RD ST
Practice Address - Street 2:SUITE 2030
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2437
Practice Address - Country:US
Practice Address - Phone:602-264-7273
Practice Address - Fax:602-264-7294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3040207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ323436Medicaid
AZ323436Medicaid
AZ74782Medicare PIN