Provider Demographics
NPI:1417561515
Name:CAMELBACK INTERVENTIONAL PAIN PLLC
Entity Type:Organization
Organization Name:CAMELBACK INTERVENTIONAL PAIN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NORVAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:VARTEVAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-893-1069
Mailing Address - Street 1:4400 N SCOTTSDALE RD STE 9-332
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3331
Mailing Address - Country:US
Mailing Address - Phone:214-893-1069
Mailing Address - Fax:
Practice Address - Street 1:6040 E LAFAYETTE BLVD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3028
Practice Address - Country:US
Practice Address - Phone:214-893-1069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty