Healthcare Provider Details

I. General information

NPI: 1265809867
Provider Name (Legal Business Name): PHOENICIAN FOOT & ANKLE SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2015
Last Update Date: 09/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11000 N SCOTTSDALE RD STE 270
SCOTTSDALE AZ
85254-5270
US

IV. Provider business mailing address

11000 N SCOTTSDALE RD STE 270
SCOTTSDALE AZ
85254-5270
US

V. Phone/Fax

Practice location:
  • Phone: 480-253-9996
  • Fax: 844-733-9353
Mailing address:
  • Phone: 480-253-9996
  • Fax: 844-733-9353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0795
License Number StateAZ

VIII. Authorized Official

Name: DR. NIMA SANA
Title or Position: PODIATRIST
Credential: DPM
Phone: 602-363-3846