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EAST MESA FAMILY DOCTORS PLLC NPI 1508310665


NPI Information

NPI: 1508310665
Provider Name: EAST MESA FAMILY DOCTORS PLLC

Former Legal Business Name: MEDICAL MALL OF ARIZONA FAMILY PRACTICE PLLC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 03D2130971

Address:
7165 E UNIVERSITY DR STE 101
MESA, AZ
ZIP 85207
Phone: (480) 999-0049
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EAST MESA FAMILY DOCTORS PLLC is a family medicine in Mesa, AZ. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. EAST MESA FAMILY DOCTORS PLLC NPI is 1508310665. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Medical Mall Of Arizona Family Practice Pllc.

The provider's business location address is:

7165 E UNIVERSITY DR STE 101
MESA, AZ
ZIP 85207-400
Phone: (480) 999-0049
Fax: (866) 918-8525

The provider's authorized official is Stacy Deann Veldhuizen Mickey .
The authorized official title is Md/owner and has the following contact phone number (480) 999-0049.

The CLIA number assigned to this NPI record is 03D2130971 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/6/2016 and was last updated on 12/14/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineARIZONAYes

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.