Provider Demographics
NPI:1124114665
Name:CARDIOVASCULAR ASSOCIATES OF MESA-GILBERT
Entity type:Organization
Organization Name:CARDIOVASCULAR ASSOCIATES OF MESA-GILBERT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEB
Authorized Official - Middle Name:
Authorized Official - Last Name:TELLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-641-5400
Mailing Address - Street 1:6335 E MAIN ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-8965
Mailing Address - Country:US
Mailing Address - Phone:480-641-5400
Mailing Address - Fax:480-218-4705
Practice Address - Street 1:6335 E MAIN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-8965
Practice Address - Country:US
Practice Address - Phone:480-641-5400
Practice Address - Fax:480-218-4705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty