Basic Information
Provider Information
NPI: 1356395271
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZANGWILL
FirstName: STEVEN
MiddleName: D
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3200 E CAMELBACK RD STE 250
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850182327
CountryCode: US
TelephoneNumber: 6029331815
FaxNumber:  
Practice Location
Address1: 1919 E THOMAS RD
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850167710
CountryCode: US
TelephoneNumber: 6029333366
FaxNumber: 6029334264
Other Information
ProviderEnumerationDate: 05/22/2006
LastUpdateDate: 02/17/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/17/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0202X50031AZY Allopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology

ID Information
IDTypeStateIssuerDescription
00320605AZ MEDICAID


Home