Healthcare Provider Details

I. General information

NPI: 1003899048
Provider Name (Legal Business Name): AMBER N BROOKS-GUMBERT P.A.-C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMBER N BROOKS PA-C

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13400 E SHEA BLVD
SCOTTSDALE AZ
85259-5452
US

IV. Provider business mailing address

13400 E SHEA BLVD
SCOTTSDALE AZ
85259-5452
US

V. Phone/Fax

Practice location:
  • Phone: 480-301-8000
  • Fax:
Mailing address:
  • Phone: 480-301-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3280
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number3280
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: