Arizona Center for Minimally Invasive Surgery LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

34753 Issued in AZ

Legal business name

ARIZONA CENTER FOR MINIMALLY INVASIVE SURGERY LLC

Practice address

1475 W Chandler Blvd
Chandler, AZ 85224-6257

Phone

(623) 544-7266

Fax

(623) 321-1965

NPI assigned

Jan 30, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. L Philipp Wall, MD

Title

Owner

Phone

(623) 544-7266

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410998400000",
    "number": "1164794772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15571 N REEMS RD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853749584",
            "telephone_number": "623-544-7266",
            "fax_number": "623-321-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 W CHANDLER BLVD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246257",
            "telephone_number": "623-544-7266",
            "fax_number": "623-321-1965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA CENTER FOR MINIMALLY INVASIVE SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-30",
        "last_updated": "2014-09-18",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "L PHILIPP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-544-7266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "34753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.