Healthcare Provider Details

I. General information

NPI: 1699608489
Provider Name (Legal Business Name): NEIGHBORHOOD CLINIC NV LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 W CHANDLER BLVD STE B11
CHANDLER AZ
85224-6128
US

IV. Provider business mailing address

8488 ROZITA LEE AVE
LAS VEGAS NV
89113-4771
US

V. Phone/Fax

Practice location:
  • Phone: 480-935-7949
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TRENT HOFMOCKEL
Title or Position: PRESIDENT
Credential:
Phone: 702-425-8105