Provider Demographics
NPI:1891816625
Name:GURGOZE, ERDAL M (PHD)
Entity Type:Individual
Prefix:
First Name:ERDAL
Middle Name:M
Last Name:GURGOZE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W CLARENDON AVE STE 350
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3497
Mailing Address - Country:US
Mailing Address - Phone:602-274-4484
Mailing Address - Fax:602-287-9406
Practice Address - Street 1:1916 W BETHANY HOME RD # E100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-2458
Practice Address - Country:US
Practice Address - Phone:602-274-4484
Practice Address - Fax:602-287-9406
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAMERICAN BOARD 2524OtherRADIOLOGIC PHYSICS