Provider Demographics
NPI:1245470798
Name:DESERT SPRINGS CANCER CARE, PLC
Entity type:Organization
Organization Name:DESERT SPRINGS CANCER CARE, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:BURESH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-585-4673
Mailing Address - Street 1:21803 N SCOTTSDALE RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-7444
Mailing Address - Country:US
Mailing Address - Phone:480-585-4673
Mailing Address - Fax:480-585-4672
Practice Address - Street 1:21803 N SCOTTSDALE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7444
Practice Address - Country:US
Practice Address - Phone:480-585-4673
Practice Address - Fax:480-585-4672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-24
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30123207RX0202X
AZ35043207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ088377Medicaid
118366Medicare PIN
AZ088377Medicaid