Healthcare Provider Details

I. General information

NPI: 1407221286
Provider Name (Legal Business Name): ARSHAD AZIZ PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2015
Last Update Date: 02/09/2022
Certification Date: 02/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W GLENDALE AVE SUITE 203
PHOENIX AZ
85021-7677
US

IV. Provider business mailing address

2201 W FAIRVIEW ST STE 1
CHANDLER AZ
85224-4712
US

V. Phone/Fax

Practice location:
  • Phone: 602-772-5770
  • Fax: 602-772-5771
Mailing address:
  • Phone: 480-800-4890
  • Fax: 480-427-4766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number6130
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: