Provider Demographics
NPI:1811752678
Name:ARIZONA LUNG CLINIC PLLC
Entity type:Organization
Organization Name:ARIZONA LUNG CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:JULIAN
Authorized Official - Last Name:ARANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-440-3136
Mailing Address - Street 1:PO BOX 8270
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-0121
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13657 W MCDOWELL RD
Practice Address - Street 2:STE #210
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85338
Practice Address - Country:US
Practice Address - Phone:623-242-9830
Practice Address - Fax:623-249-5181
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARIZONA LUNG CLINIC PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty