Healthcare Provider Details

I. General information

NPI: 1770197873
Provider Name (Legal Business Name): CAMELBACK PAIN CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2020
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5410 N SCOTTSDALE RD STE I-100A
PARADISE VALLEY AZ
85253-5927
US

IV. Provider business mailing address

5410 N SCOTTSDALE RD STE I-100A
SCOTTSDALE AZ
85253-5927
US

V. Phone/Fax

Practice location:
  • Phone: 480-572-2444
  • Fax: 602-581-7158
Mailing address:
  • Phone: 480-572-2444
  • Fax: 602-581-7158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: LISA DUBIEL
Title or Position: DIRECTOR
Credential:
Phone: 480-572-2444