Provider Demographics
NPI:1366863524
Name:ARIZONA TRANSPLANT ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:ARIZONA TRANSPLANT ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:FABREGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-253-2262
Mailing Address - Street 1:1300 N 12TH ST.
Mailing Address - Street 2:SUITE 409
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2852
Mailing Address - Country:US
Mailing Address - Phone:602-253-2262
Mailing Address - Fax:602-253-7191
Practice Address - Street 1:1300 N 12TH ST.
Practice Address - Street 2:SUITE 409
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2852
Practice Address - Country:US
Practice Address - Phone:602-253-2262
Practice Address - Fax:602-253-7191
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARIZONA TRANSPLANT ASSOCIATES, P.C
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25884174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty