Provider Demographics
NPI:1598011025
Name:AMBULATORY MEDICAL ASSOCIATES-CO, PLLC
Entity Type:Organization
Organization Name:AMBULATORY MEDICAL ASSOCIATES-CO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-687-8189
Mailing Address - Street 1:8433 N BLACK CANYON HWY STE 130
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-4859
Mailing Address - Country:US
Mailing Address - Phone:602-687-8189
Mailing Address - Fax:888-505-6003
Practice Address - Street 1:8433 N BLACK CANYON HWY STE 130
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-4859
Practice Address - Country:US
Practice Address - Phone:602-687-8189
Practice Address - Fax:888-505-6003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR51450207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty