Provider Demographics
NPI:1932625779
Name:ARIZONA HEART 360, P.C.
Entity Type:Organization
Organization Name:ARIZONA HEART 360, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SARIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:818-434-1956
Mailing Address - Street 1:13208 N 13TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-4932
Mailing Address - Country:US
Mailing Address - Phone:818-434-1956
Mailing Address - Fax:
Practice Address - Street 1:20045 N 19TH AVE STE 165
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4254
Practice Address - Country:US
Practice Address - Phone:623-404-3115
Practice Address - Fax:623-215-7670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-14
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0005794207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty