Provider Demographics
NPI:1528074010
Name:DESERT NEPHROLOGY & HYPERTENSION, INC.
Entity type:Organization
Organization Name:DESERT NEPHROLOGY & HYPERTENSION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:PARISE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-583-6420
Mailing Address - Street 1:10503 W THUNDERBIRD BLVD STE 113
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-3047
Mailing Address - Country:US
Mailing Address - Phone:623-583-6420
Mailing Address - Fax:623-583-6421
Practice Address - Street 1:10503 W THUNDERBIRD BLVD STE 113
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3047
Practice Address - Country:US
Practice Address - Phone:623-583-6420
Practice Address - Fax:623-583-6421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZDA5355Medicare PIN
AZZ71533Medicare PIN