Faca Vascular

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

FACA VASCULAR

Practice address

1831 E Queen Creek Rd Ste 120
Chandler, AZ 85286-2019

Phone

(314) 973-9571

NPI assigned

Jan 20, 2018

Organization subpart

No

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

Authorized official

Name

Hamblen Dean Fuller

Title

Organiser

Phone

(602) 793-0310

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1516406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516406400000",
    "number": "1689182966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1831 E QUEEN CREEK RD STE 120",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852862019",
            "telephone_number": "314-973-9571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1831 E QUEEN CREEK RD STE 120",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852862019",
            "telephone_number": "314-973-9571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACA VASCULAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-20",
        "last_updated": "2018-01-20",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "HAMBLEN",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "ORGANISER",
        "authorized_official_telephone_number": "602-793-0310"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Diagnostic Radiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2018; 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.