Provider Demographics
NPI:1992860233
Name:MEDICAL DIAGNOSTIC AND CARE CENTER INC
Entity Type:Organization
Organization Name:MEDICAL DIAGNOSTIC AND CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HAVHANNES
Authorized Official - Middle Name:T
Authorized Official - Last Name:KARAGEZYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-795-1555
Mailing Address - Street 1:926 E MCDOWELL RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2503
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:926 E MCDOWELL RD
Practice Address - Street 2:SUITE 107
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2503
Practice Address - Country:US
Practice Address - Phone:602-795-1555
Practice Address - Fax:602-795-6054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty