PATRICIA A DIETZGEN DO LLC NPI 1255529491

NPI Information

NPI: 1255529491
Provider Name: PATRICIA A DIETZGEN DO LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
16515 S 40TH ST
SUITE 103
PHOENIX, AZ
ZIP 85048
Phone: (480) 961-0760
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PATRICIA A DIETZGEN DO LLC is a primary care clinic center in Phoenix, AZ. PATRICIA A DIETZGEN DO LLC NPI is 1255529491. The provider is registered as an organization entity type.

The provider's business location address is:

16515 S 40TH ST
SUITE 103
PHOENIX, AZ
ZIP 85048-558
Phone: (480) 961-0760
Fax: (480) 961-0761

The provider's authorized official is Patricia A Dietzgen .
The authorized official title is Owner and has the following contact phone number (480) 961-0760.

The enumeration date for this NPI number is 10/12/2007 and was last updated on 1/19/2011.

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	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DE7249	OTHER	ARIZONA	PALMETO GBA
2	81628	MEDICARE PIN	ARIZONA

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

NPI Synchronization or Removal

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