Healthcare Provider Details

I. General information

NPI: 1306396601
Provider Name (Legal Business Name): QC MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2016
Last Update Date: 10/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21323 S ELLSWORTH LOOP RD # 101
QUEEN CREEK AZ
85142-9864
US

IV. Provider business mailing address

1450 W GUADALUPE RD
GILBERT AZ
85233-3042
US

V. Phone/Fax

Practice location:
  • Phone: 480-497-2900
  • Fax: 480-926-2260
Mailing address:
  • Phone: 480-926-7800
  • Fax: 480-926-2260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: MINOO RAHIMINEJAD
Title or Position: PARTNER
Credential:
Phone: 480-926-7800