Healthcare Provider Details

I. General information

NPI: 1750205878
Provider Name (Legal Business Name): LPAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 W MAPLEWOOD ST
CHANDLER AZ
85286-6364
US

IV. Provider business mailing address

1002 W MAPLEWOOD ST
CHANDLER AZ
85286-6364
US

V. Phone/Fax

Practice location:
  • Phone: 520-241-7230
  • Fax:
Mailing address:
  • Phone: 520-241-7230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: LISA KELLER
Title or Position: MANAGER
Credential: PA-C
Phone: 520-241-7230