Provider Demographics
NPI:1972502227
Name:ARIZONA CENTER FOR HAND SURGERY PC
Entity Type:Organization
Organization Name:ARIZONA CENTER FOR HAND SURGERY PC
Other - Org Name:ARIZONA CENTER FOR HAND TO SHOULDER SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-258-4788
Mailing Address - Street 1:PO BOX 7587
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85011-7587
Mailing Address - Country:US
Mailing Address - Phone:602-258-4788
Mailing Address - Fax:602-258-5131
Practice Address - Street 1:370 E VIRGINIA AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1214
Practice Address - Country:US
Practice Address - Phone:602-258-4788
Practice Address - Fax:602-258-5131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ207XS0106X, 2086S0105X
2082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Single Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ277349Medicaid
AZZ68697Medicare ID - Type Unspecified