Healthcare Provider Details

I. General information

NPI: 1033507033
Provider Name (Legal Business Name): ARIZONA DOCTORS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2014
Last Update Date: 04/29/2022
Certification Date: 04/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6739 W CACTUS RD
PEORIA AZ
85381-5311
US

IV. Provider business mailing address

6739 W CACTUS RD
PEORIA AZ
85381-5311
US

V. Phone/Fax

Practice location:
  • Phone: 623-240-1110
  • Fax: 623-889-0814
Mailing address:
  • Phone: 623-240-1110
  • Fax: 623-889-0814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KEQIANG SHEN
Title or Position: CHIEF CLINICIAN OFFICER
Credential: NP
Phone: 602-626-4473