Provider Demographics
NPI:1932925518
Name:ARIZONA ADVANCED HEART & LUNG SPECIALISTS LLC
Entity type:Organization
Organization Name:ARIZONA ADVANCED HEART & LUNG SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAO
Authorized Official - Middle Name:KENITH
Authorized Official - Last Name:FANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-999-2084
Mailing Address - Street 1:3219 E CAMELBACK RD # 260
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2307
Mailing Address - Country:US
Mailing Address - Phone:602-881-1976
Mailing Address - Fax:
Practice Address - Street 1:3131 E CLARENDON AVE STE 101
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7069
Practice Address - Country:US
Practice Address - Phone:602-881-1976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty