Healthcare Provider Details

I. General information

NPI: 1497854269
Provider Name (Legal Business Name): PULMONARY ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 E BROADWAY RD STE 107
MESA AZ
85206-1346
US

IV. Provider business mailing address

5151 E BROADWAY RD STE 107
MESA AZ
85206-1346
US

V. Phone/Fax

Practice location:
  • Phone: 480-290-7000
  • Fax: 480-325-3461
Mailing address:
  • Phone: 480-290-7000
  • Fax: 602-254-6840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number StateAZ

VIII. Authorized Official

Name: CECILIA JENKINS
Title or Position: ASSISTANT ADMINISTRATOR
Credential:
Phone: 480-290-7000