Healthcare Provider Details

I. General information

NPI: 1447910229
Provider Name (Legal Business Name): EXCEPTIONAL PHYSICIANS GROUP ARIZONA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2021
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19060 N JOHN WAYNE PARKWAY
MARICOPA AZ
85139
US

IV. Provider business mailing address

3514 CEDAR SPRINGS RD
DALLAS TX
75219-4901
US

V. Phone/Fax

Practice location:
  • Phone: 480-631-0678
  • Fax:
Mailing address:
  • Phone: 469-341-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: SAEED S MAHBOUBI
Title or Position: CEO
Credential:
Phone: 214-533-0034