CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC NPI 1376178129

NPI Information

NPI: 1376178129
Provider Name: CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC

Doing Business As: CLEANSLATE CENTERS- GILBERT, AZ.

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
2451 E BASELINE RD STE 430
GILBERT, AZ
ZIP 85234
Phone: (602) 313-4391
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CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC is a multi-specialty clinic center in Gilbert, AZ. CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC NPI is 1376178129. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Cleanslate Centers- Gilbert, Az..

The provider's business location address is:

2451 E BASELINE RD STE 430
GILBERT, AZ
ZIP 85234-473
Phone: (602) 313-4391

The provider's authorized official is Jessica Amick .
The authorized official title is Ao and has the following contact phone number (727) 798-8160.

The enumeration date for this NPI number is 3/11/2020 and was last updated on 3/23/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207R00000X	Internal Medicine		No
2	261QM0850X	Clinic/Center	Adult Mental Health	No
3	261QM1300X	Clinic/Center	Multi-Specialty	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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