Provider Demographics
NPI:1013612506
Name:ARIZONA CARDIOVASCULAR LLC
Entity Type:Organization
Organization Name:ARIZONA CARDIOVASCULAR LLC
Other - Org Name:AZ CARDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KISHLAY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-654-1950
Mailing Address - Street 1:PO BOX 6299
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85385-6299
Mailing Address - Country:US
Mailing Address - Phone:602-654-1950
Mailing Address - Fax:602-848-4880
Practice Address - Street 1:13943 N 91ST AVE STE A101
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-3688
Practice Address - Country:US
Practice Address - Phone:602-654-1950
Practice Address - Fax:602-848-4880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty