Healthcare Provider Details

I. General information

NPI: 1659284958
Provider Name (Legal Business Name): ADIB MEHRPOUYA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 W GUADALUPE RD # ED
MESA AZ
85202-9101
US

IV. Provider business mailing address

1225 W GUADALUPE RD # RE
MESA AZ
85202-9101
US

V. Phone/Fax

Practice location:
  • Phone: 480-838-7452
  • Fax:
Mailing address:
  • Phone: 480-838-7452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS028097
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: