Healthcare Provider Details
I. General information
NPI: 1063982155
Provider Name (Legal Business Name): MULTICARE MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/30/2018
Last Update Date: 08/19/2021
Certification Date: 08/19/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
754 S VAL VISTA DR STE 105
GILBERT AZ
85296-3139
US
IV. Provider business mailing address
754 S VAL VISTA DR STE 105
GILBERT AZ
85296-3139
US
V. Phone/Fax
- Phone: 480-497-2900
- Fax:
- Phone: 480-926-7800
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NR0400X |
| Taxonomy | Rehabilitation Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GREG
VOGEL
Title or Position: OWNER
Credential: DC
Phone: 480-497-2900