Provider Demographics
NPI:1780127266
Name:ARIZONA CARDIOVASCULAR CARE
Entity type:Organization
Organization Name:ARIZONA CARDIOVASCULAR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERVENTIONAL CARDIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:GHASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAIJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-878-4077
Mailing Address - Street 1:PO BOX 45200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85064-5200
Mailing Address - Country:US
Mailing Address - Phone:480-878-4077
Mailing Address - Fax:480-498-5269
Practice Address - Street 1:1847 E SOUTHERN AVE STE 4
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5881
Practice Address - Country:US
Practice Address - Phone:480-878-4077
Practice Address - Fax:480-498-5269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-30
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ48310207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty