Provider Demographics
NPI:1467788414
Name:GRAND CANYON ANESTHESIOLOGY CONSULTANTS PLC
Entity Type:Organization
Organization Name:GRAND CANYON ANESTHESIOLOGY CONSULTANTS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAFEZ
Authorized Official - Middle Name:
Authorized Official - Last Name:AZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-343-2900
Mailing Address - Street 1:5110 N 44TH ST
Mailing Address - Street 2:SUITE L 200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-1649
Mailing Address - Country:US
Mailing Address - Phone:602-343-2900
Mailing Address - Fax:602-343-2901
Practice Address - Street 1:5110 N 44TH ST
Practice Address - Street 2:SUITE L 200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-1649
Practice Address - Country:US
Practice Address - Phone:602-343-2900
Practice Address - Fax:602-343-2901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty