Provider Demographics
NPI:1154777647
Name:INTEGRASURGICAL AMBULATORY CENTERS OF ARIZONA
Entity type:Organization
Organization Name:INTEGRASURGICAL AMBULATORY CENTERS OF ARIZONA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SNEHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BHOOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-362-0922
Mailing Address - Street 1:6859 E REMBRANDT AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-3628
Mailing Address - Country:US
Mailing Address - Phone:602-362-0922
Mailing Address - Fax:
Practice Address - Street 1:6859 E REMBRANDT AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-3628
Practice Address - Country:US
Practice Address - Phone:602-362-0922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-13
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical