Provider Demographics
NPI:1306838123
Name:CHIRBAN, ANGELO (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:
Last Name:CHIRBAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3337 N MILLER RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6495
Mailing Address - Country:US
Mailing Address - Phone:480-990-1280
Mailing Address - Fax:480-990-1410
Practice Address - Street 1:3337 N MILLER RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6495
Practice Address - Country:US
Practice Address - Phone:480-990-1280
Practice Address - Fax:480-990-1410
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27055174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZC45246Medicare UPIN
AZZ75693Medicare PIN