Healthcare Provider Details
I. General information
NPI: 1992932206
Provider Name (Legal Business Name): ALEXANDER DE SOLER NMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/12/2009
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6345 E BELL RD STE 4
SCOTTSDALE AZ
85254-6451
US
IV. Provider business mailing address
9366 E PINE VALLEY RD
SCOTTSDALE AZ
85260-2843
US
V. Phone/Fax
- Phone: 480-398-4000
- Fax:
- Phone: 480-236-0974
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | 09-1121 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175F00000X |
| Taxonomy | Naturopath |
| License Number | 09-1121 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: