Provider Demographics
NPI:1467522987
Name:SCOTTSDALE CENTER FOR ADVANCED PAIN MANAGEMENT, PC
Entity Type:Organization
Organization Name:SCOTTSDALE CENTER FOR ADVANCED PAIN MANAGEMENT, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:B
Authorized Official - Last Name:SANEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-661-8588
Mailing Address - Street 1:9500 E. IRONWOOD SQUARE DRIVE
Mailing Address - Street 2:SUITE 125
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4582
Mailing Address - Country:US
Mailing Address - Phone:602-570-3169
Mailing Address - Fax:623-888-8570
Practice Address - Street 1:9500 E. IRONWOOD SQUARE DRIVE
Practice Address - Street 2:SUITE 125
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4582
Practice Address - Country:US
Practice Address - Phone:480-626-2552
Practice Address - Fax:480-626-2551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ399234Medicaid