Healthcare Provider Details

I. General information

NPI: 1316723620
Provider Name (Legal Business Name): TEMPE JOINT AND SPINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2023
Last Update Date: 07/15/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E WARNER RD STE 103
TEMPE AZ
85284-3224
US

IV. Provider business mailing address

2919 S ELLSWORTH RD STE 109
MESA AZ
85212-2165
US

V. Phone/Fax

Practice location:
  • Phone: 480-597-4321
  • Fax: 883-559-0886
Mailing address:
  • Phone: 480-597-4321
  • Fax: 883-559-0886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: JAMAL DABBAH
Title or Position: CLINIC CO-OWNER
Credential: MD
Phone: 480-597-4321