Healthcare Provider Details

I. General information

NPI: 1578316428
Provider Name (Legal Business Name): HONORHEALTH MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2024
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7242 E OSBORN RD STE 520
SCOTTSDALE AZ
85251-6487
US

IV. Provider business mailing address

PO BOX 845406
LOS ANGELES CA
90084-0012
US

V. Phone/Fax

Practice location:
  • Phone: 623-683-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN NEIL
Title or Position: CMO
Credential:
Phone: 480-587-5123