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NPI Code Detail

MEDICARE: NORTH PHOENIX MEDICAL GROUP LLC

MEDICARE: NORTH PHOENIX MEDICAL GROUP LLC
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
1111N00000XChiropractor
2207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1982223392
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH PHOENIX MEDICAL GROUP LLC
Provider Business Mailing Address
First Line : 2302 W GREENWAY RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85023-4235
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2302 W GREENWAY RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85023-4235
Country : US
Telephone Number : 602-548-1998
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. ANGELO PISANO
Credential :
Telephone Number : 602-548-1998
Provider Enumeration Date : 04/15/2020
Last Update Date : 04/15/2020

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Directions to “NORTH PHOENIX MEDICAL GROUP LLC ” Practice Location

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