Provider Demographics
NPI:1710047188
Name:ARROWHEAD ENDOSCOPY AND PAIN MANAGEMENT CENTER LLC
Entity Type:Organization
Organization Name:ARROWHEAD ENDOSCOPY AND PAIN MANAGEMENT CENTER LLC
Other - Org Name:ARROWHEAD ENDOSCOPY CENTER.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SUKHDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:PADDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-376-8600
Mailing Address - Street 1:7168 W CAMPO BELLO DR., STE A
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308
Mailing Address - Country:US
Mailing Address - Phone:623-376-8600
Mailing Address - Fax:623-321-1166
Practice Address - Street 1:7168 W CAMPO BELLO DR., STE A
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308
Practice Address - Country:US
Practice Address - Phone:623-376-8600
Practice Address - Fax:623-321-1166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ113718Medicare PIN