Provider Demographics
NPI:1821465584
Name:ARIZONA MEDICAL ASSOCIATES INC
Entity Type:Organization
Organization Name:ARIZONA MEDICAL ASSOCIATES INC
Other - Org Name:RALPH A D'SILVA M.D
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:D'SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-258-0489
Mailing Address - Street 1:PO BOX 2925 E RIGGS RD
Mailing Address - Street 2:STE.8 PMB179
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-3600
Mailing Address - Country:US
Mailing Address - Phone:480-258-0489
Mailing Address - Fax:480-247-3251
Practice Address - Street 1:1301 SOUTH RISMON ROAD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-3767
Practice Address - Country:US
Practice Address - Phone:480-258-0489
Practice Address - Fax:480-718-7313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-28
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36884174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ224192Medicaid