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BANNER PHYSICIAN SPECIALISTS ARIZONA LLC NPI 1316228802


NPI Information

NPI: 1316228802
Provider Name: BANNER PHYSICIAN SPECIALISTS ARIZONA LLC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 03D2123901

Address:
37100 N GANTZEL RD
STE 107
SAN TAN VALLEY, AZ
ZIP 85140
Phone: (480) 394-4480
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BANNER PHYSICIAN SPECIALISTS ARIZONA LLC is a multi-specialty clinic center in San Tan Valley, AZ. BANNER PHYSICIAN SPECIALISTS ARIZONA LLC NPI is 1316228802. The provider is registered as an organization entity type.

The provider's business location address is:

37100 N GANTZEL RD
STE 107
SAN TAN VALLEY, AZ
ZIP 85140-349
Phone: (480) 394-4480

The provider's authorized official is Dennis Laraway .
The authorized official title is Cfo and has the following contact phone number (602) 747-4000.

The CLIA number assigned to this NPI record is 03D2123901 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/29/2011 and was last updated on 12/29/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM1300XClinic/CenterMulti-SpecialtyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.