Healthcare Provider Details

I. General information

NPI: 1558545509
Provider Name (Legal Business Name): JORDI SPARTACO LIVI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 02/24/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6380 E THOMAS RD STE 100
SCOTTSDALE AZ
85251-7033
US

IV. Provider business mailing address

11000 N SCOTTSDALE RD # AZ 110
SCOTTSDALE AZ
85254-6130
US

V. Phone/Fax

Practice location:
  • Phone: 480-607-0606
  • Fax: 480-498-3725
Mailing address:
  • Phone: 480-607-0606
  • Fax: 480-498-3725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number41583
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: