Provider Demographics
NPI:1053547331
Name:ARIZONA HEART AND ARRHYTHMIA CLINIC
Entity type:Organization
Organization Name:ARIZONA HEART AND ARRHYTHMIA CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:
Authorized Official - Last Name:GARG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-289-8759
Mailing Address - Street 1:5006 E CANNON DR
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-1062
Mailing Address - Country:US
Mailing Address - Phone:480-289-8759
Mailing Address - Fax:480-275-2700
Practice Address - Street 1:1450 S DOBSON RD STE A110
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4739
Practice Address - Country:US
Practice Address - Phone:480-264-6655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27507207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ432803Medicaid
AZ511768Medicaid