Comet Anesthesia LLC
Anesthesiology in Peoria, AZ. Organization (NPI-2).
NPI number1700424363
StatusActive
Last updated in NPPESDec 16, 2019
Details
- NPI
- 1700424363
- Entity type
- Organization (NPI-2)
- Legal business name
- Comet Anesthesia LLC
- Organization subpart
- No
- Enumeration date
- Dec 13, 2019
- Certification date
- Dec 16, 2019
- Last updated
- Dec 16, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207L00000X | Anesthesiology | – | – | Yes |
Practice location
13660 N 94th Dr # D-1Peoria, AZ 85381-4836
Phone 623-230-2912
Mailing address
13660 N 94th Dr # D-1Peoria, AZ 85381-4836
Phone 623-230-2912
Authorized official
Steven Shane Moore
Provider/Owner
6239740522
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