Basic Information
| Provider Information | |||||||||
| NPI: | 1467759092 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARIZONA PHYSICIAN CONSULTANTS PROFESSIONAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | DEPT 5258 | ||||||||
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| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900845258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3304703700 | ||||||||
| FaxNumber: | 3304703753 | ||||||||
| Practice Location | |||||||||
| Address1: | 1501 W 24TH ST | ||||||||
| Address2: | |||||||||
| City: | YUMA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853646373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9287266335 | ||||||||
| FaxNumber: | 9287266501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2011 | ||||||||
| LastUpdateDate: | 04/15/2011 | ||||||||
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| AuthorizedOfficialLastName: | EHLERT | ||||||||
| AuthorizedOfficialFirstName: | KURT | ||||||||
| AuthorizedOfficialMiddleName: | J. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9287266335 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.