Provider Demographics
NPI:1568598886
Name:ARIZONA CHILDREN'S GASTROENTEROLOGY, P.C.
Entity Type:Organization
Organization Name:ARIZONA CHILDREN'S GASTROENTEROLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:GILBERTO
Authorized Official - Last Name:MONTES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-391-8989
Mailing Address - Street 1:1432 S DOBSON RD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-4768
Mailing Address - Country:US
Mailing Address - Phone:480-391-8989
Mailing Address - Fax:480-391-8985
Practice Address - Street 1:1432 S DOBSON RD
Practice Address - Street 2:SUITE 402
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4768
Practice Address - Country:US
Practice Address - Phone:480-391-8989
Practice Address - Fax:480-391-8985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ26440261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center