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NPI Code Detail

MEDICARE: U.S. HEALTHWORKS MEDICAL GROUP OF ARIZONA, INC.

MEDICARE: U.S. HEALTHWORKS MEDICAL GROUP OF ARIZONA, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12083P0500XPreventive Medicine/Occupational Environmental Medicine Physician
2261QU0200XUrgent Care Clinic/Center

General Provider Information

NPI Number : 1619427218
Entity Type Code : Organization
Provider Name (Legal Business Name) : U.S. HEALTHWORKS MEDICAL GROUP OF ARIZONA, INC.
Provider Business Mailing Address
First Line : 25124 SPRINGFIELD CT
Second Line : SUITE 200
City : VALENCIA
State : CA
Zip : 91355-1085
Country : US
Telephone Number : 661-678-2600
Fax Number :
Provider Business Practice Location Address
First Line : 2010 N 75TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85035-3247
Country : US
Telephone Number : 623-245-6695
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : JOSEPH T MALLAS
Credential :
Telephone Number : 661-678-2600
Provider Enumeration Date : 10/06/2016
Last Update Date : 10/06/2016

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