Healthcare Provider Details
I. General information
NPI: 1891834552
Provider Name (Legal Business Name): M.B. BEST MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/06/2007
Last Update Date: 04/07/2022
Certification Date: 04/07/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8618 N 35TH AVE 3
PHOENIX AZ
85051-3800
US
IV. Provider business mailing address
8618 N 35TH AVE 3
PHOENIX AZ
85051-3800
US
V. Phone/Fax
- Phone: 602-249-0999
- Fax: 602-249-6020
- Phone: 602-249-0999
- Fax: 602-249-6020
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | 3290 |
| License Number State | AZ |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 34954 |
| License Number State | AZ |
VIII. Authorized Official
Name:
ALBERT
LANCHIAN
Title or Position: MANAGER
Credential:
Phone: 818-303-6737