Provider Demographics
NPI:1386167120
Name:DESERT SURGICAL SPECIALISTS, PLLC
Entity type:Organization
Organization Name:DESERT SURGICAL SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DURRANI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:602-663-9371
Mailing Address - Street 1:19646 N 27TH AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4026
Mailing Address - Country:US
Mailing Address - Phone:602-663-9337
Mailing Address - Fax:602-456-6887
Practice Address - Street 1:19646 N 27TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4026
Practice Address - Country:US
Practice Address - Phone:602-663-9371
Practice Address - Fax:602-456-6887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-24
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty