Provider Demographics
NPI:1629499009
Name:PINNACLE ANESTHESIA CONSULTANTS PLLC
Entity Type:Organization
Organization Name:PINNACLE ANESTHESIA CONSULTANTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:K
Authorized Official - Last Name:MATHUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-888-5421
Mailing Address - Street 1:1909 E RAY RD
Mailing Address - Street 2:STE 9 154
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-8724
Mailing Address - Country:US
Mailing Address - Phone:480-888-5421
Mailing Address - Fax:855-847-8908
Practice Address - Street 1:1909 E RAY RD
Practice Address - Street 2:STE 9 154
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-8724
Practice Address - Country:US
Practice Address - Phone:480-888-5421
Practice Address - Fax:855-847-8908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-02
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36299207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty