Healthcare Provider Details

I. General information

NPI: 1033640529
Provider Name (Legal Business Name): DEVIN LEE HON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2017
Last Update Date: 08/14/2020
Certification Date: 08/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S PHELPS DR
APACHE JUNCTION AZ
85120-6700
US

IV. Provider business mailing address

PO BOX 7060
CHANDLER AZ
85246-7060
US

V. Phone/Fax

Practice location:
  • Phone: 480-536-6850
  • Fax: 480-718-1301
Mailing address:
  • Phone: 480-536-6850
  • Fax: 480-718-1301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number008411
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: