Provider Demographics
NPI:1023686904
Name:CVDWESTGATE LLC
Entity type:Organization
Organization Name:CVDWESTGATE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-234-2542
Mailing Address - Street 1:6751 N SUNSET BLVD STE E333
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-3154
Mailing Address - Country:US
Mailing Address - Phone:623-234-2542
Mailing Address - Fax:623-234-2543
Practice Address - Street 1:6751 N SUNSET BLVD STE E333
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85305-3154
Practice Address - Country:US
Practice Address - Phone:623-234-2542
Practice Address - Fax:623-234-2543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-16
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty