Provider Demographics
NPI:1871735001
Name:DESERT CARDIOVASCULAR SURGEONS LLC
Entity type:Organization
Organization Name:DESERT CARDIOVASCULAR SURGEONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALPERN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-737-4445
Mailing Address - Street 1:21579 N 56TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6287
Mailing Address - Country:US
Mailing Address - Phone:610-737-4445
Mailing Address - Fax:623-266-3889
Practice Address - Street 1:21579 N 56TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-6287
Practice Address - Country:US
Practice Address - Phone:610-737-4445
Practice Address - Fax:623-266-3889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3749202K00000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Multi-Specialty