Provider Demographics
NPI:1922052547
Name:HEALTH CARE PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:HEALTH CARE PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:K
Authorized Official - Last Name:SRIVASTAVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-219-6100
Mailing Address - Street 1:2001 W ORANGE GROVE RD
Mailing Address - Street 2:SUITE 504
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-1139
Mailing Address - Country:US
Mailing Address - Phone:520-219-6100
Mailing Address - Fax:
Practice Address - Street 1:2001 W ORANGE GROVE RD
Practice Address - Street 2:STE. 504
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1139
Practice Address - Country:US
Practice Address - Phone:520-219-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27855207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ109544Medicare PIN