Healthcare Provider Details

I. General information

NPI: 1346200458
Provider Name (Legal Business Name): PAUL DAVID STRAUSS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26224 N TATUM BLVD
PHOENIX AZ
85050-7500
US

IV. Provider business mailing address

3825 E IRMA LN
PHOENIX AZ
85050-4865
US

V. Phone/Fax

Practice location:
  • Phone: 480-663-9632
  • Fax: 480-419-6782
Mailing address:
  • Phone: 480-473-9382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number1437
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: