Healthcare Provider Details

I. General information

NPI: 1043174139
Provider Name (Legal Business Name): SHEA AMBULATORY PROFESSIONALS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 E GUADALUPE RD STE 101
GILBERT AZ
85234-5116
US

IV. Provider business mailing address

2727 W FRYE RD STE 120
CHANDLER AZ
85224-4942
US

V. Phone/Fax

Practice location:
  • Phone: 623-776-2500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RADMAN RAHIMINEJAD
Title or Position: OWNER
Credential: DC
Phone: 480-926-7800