Healthcare Provider Details

I. General information

NPI: 1477143923
Provider Name (Legal Business Name): HOSHI INFECTIOUS DISEASE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2021
Last Update Date: 11/03/2021
Certification Date: 11/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18701 N 67TH AVE
GLENDALE AZ
85308-7100
US

IV. Provider business mailing address

PO BOX 20490
MESA AZ
85277-0490
US

V. Phone/Fax

Practice location:
  • Phone: 623-561-1000
  • Fax:
Mailing address:
  • Phone: 480-985-1093
  • Fax: 480-296-7665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: SAMI HOSHI
Title or Position: MD
Credential:
Phone: 480-985-1093