Healthcare Provider Details

I. General information

NPI: 1609439918
Provider Name (Legal Business Name): ALYSA BIRNBRICH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2019
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 N LA CHOLLA BLVD STE 200
TUCSON AZ
85741-3549
US

IV. Provider business mailing address

PO BOX 31630
TUCSON AZ
85751-1630
US

V. Phone/Fax

Practice location:
  • Phone: 520-784-6200
  • Fax: 520-784-6109
Mailing address:
  • Phone: 520-784-6200
  • Fax: 520-784-6109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number1609439918
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number82193
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number82193
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: