Healthcare Provider Details

I. General information

NPI: 1851233019
Provider Name (Legal Business Name): ADVANCED INJURY SOLUTIONS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 W UNIVERSITY DR
MESA AZ
85201-5205
US

IV. Provider business mailing address

2111 W UNIVERSITY DR
MESA AZ
85201-5205
US

V. Phone/Fax

Practice location:
  • Phone: 602-361-6830
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CAROLINE KHAMO
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 623-221-2289