Healthcare Provider Details

I. General information

NPI: 1124440979
Provider Name (Legal Business Name): HEALTHCARE PARTNERS ARIZONA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2014
Last Update Date: 01/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4745 N 7TH ST
PHOENIX AZ
85014-3665
US

IV. Provider business mailing address

19191 S VERMONT AVE 200
TORRANCE CA
90502-1018
US

V. Phone/Fax

Practice location:
  • Phone: 602-425-5465
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: ROBERT J. MARGOLIS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 310-354-4221