Provider Demographics
NPI:1629311329
Name:SCOTTSDALE COMPREHENSIVE PAIN CENTER
Entity Type:Organization
Organization Name:SCOTTSDALE COMPREHENSIVE PAIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VP & CFO
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:LAPORTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-882-4904
Mailing Address - Street 1:10200 N 92ND ST
Mailing Address - Street 2:MEDICAL BLDG. IV, SUITE 140
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4534
Mailing Address - Country:US
Mailing Address - Phone:480-323-3910
Mailing Address - Fax:480-323-3913
Practice Address - Street 1:10200 N 92ND ST
Practice Address - Street 2:MEDICAL BLDG. IV, SUITE 140
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4534
Practice Address - Country:US
Practice Address - Phone:480-323-3910
Practice Address - Fax:480-323-3913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain