Basic Information
| Provider Information | |||||||||
| NPI: | 1053028639 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DESERT ORTHOPEDICS CENTER PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7301 E 2ND ST STE 310 | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852515627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8778214657 | ||||||||
| FaxNumber: | 8662076786 | ||||||||
| Practice Location | |||||||||
| Address1: | 6320 W UNION HILLS DR STE 1400B | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853081061 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8778214657 | ||||||||
| FaxNumber: | 8662076786 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2022 | ||||||||
| LastUpdateDate: | 11/02/2022 | ||||||||
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| AuthorizedOfficialLastName: | AHMED | ||||||||
| AuthorizedOfficialFirstName: | SARIM | ||||||||
| AuthorizedOfficialMiddleName: | SHAKEEL | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8778214657 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 11/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332900000X | Y | Suppliers | Non-Pharmacy Dispensing Site |
No ID Information.