Healthcare Provider Details

I. General information

NPI: 1760009849
Provider Name (Legal Business Name): MORGAN ADELMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2020
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20715 E OCOTILLO RD STE 102
QUEEN CREEK AZ
85142-6118
US

IV. Provider business mailing address

PO BOX 33269
PHOENIX AZ
85067-3269
US

V. Phone/Fax

Practice location:
  • Phone: 480-987-0987
  • Fax: 480-987-0940
Mailing address:
  • Phone: 602-406-4786
  • Fax: 916-636-4358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9303
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number9303
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: