Healthcare Provider Details

I. General information

NPI: 1396718102
Provider Name (Legal Business Name): PAUL S LAVEN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3202 E GREENWAY RD STE 1401
PHOENIX AZ
85032-4511
US

IV. Provider business mailing address

3202 E GREENWAY RD STE 1401
PHOENIX AZ
85032-4511
US

V. Phone/Fax

Practice location:
  • Phone: 888-405-6396
  • Fax: 415-252-7176
Mailing address:
  • Phone: 888-405-6396
  • Fax: 415-252-7176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2821
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: