Provider Demographics
NPI:1891827473
Name:DELANTA MANAGEMENT GROUP INC
Entity type:Organization
Organization Name:DELANTA MANAGEMENT GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LEVON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAGRIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-304-0202
Mailing Address - Street 1:303 E BASELINE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-6530
Mailing Address - Country:US
Mailing Address - Phone:602-304-0202
Mailing Address - Fax:602-304-0303
Practice Address - Street 1:303 E BASELINE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-6530
Practice Address - Country:US
Practice Address - Phone:602-304-0202
Practice Address - Fax:602-304-0303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty