Healthcare Provider Details

I. General information

NPI: 1508462441
Provider Name (Legal Business Name): OPTIMIZEYOU LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2020
Last Update Date: 06/23/2021
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 S ALMA SCHOOL RD STE 15
CHANDLER AZ
85224-7633
US

IV. Provider business mailing address

2165 W PECOS RD STE 5
CHANDLER AZ
85224-4874
US

V. Phone/Fax

Practice location:
  • Phone: 480-660-8817
  • Fax: 949-577-4124
Mailing address:
  • Phone: 480-445-9189
  • Fax: 949-577-4124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PS0010X
TaxonomySports Medicine (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: SAMMIE JOBE
Title or Position: OFFICE MANAGER
Credential:
Phone: 480-660-8817