Provider Demographics
NPI:1154647378
Name:JAMES DELLARIPA, MD PLLC
Entity Type:Organization
Organization Name:JAMES DELLARIPA, MD PLLC
Other - Org Name:DELLARIPA ANESTHESIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:DELLARIPA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-726-1598
Mailing Address - Street 1:PO BOX 12817
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85267-2817
Mailing Address - Country:US
Mailing Address - Phone:480-276-1598
Mailing Address - Fax:480-275-4495
Practice Address - Street 1:1400 S DOBSON
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4707
Practice Address - Country:US
Practice Address - Phone:480-276-1598
Practice Address - Fax:480-275-4495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-13
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32823207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZI36090Medicare UPIN