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General NPI Number Information
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NPI Number | 1013365493
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Entity Type | Organization
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Legal Business Name | GERI-CARE
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Dates
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Enumeration Date | 05/26/2016
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Last Update Date | 06/07/2016
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Provider Practice Location Address
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Address Line | 6414 E JUNIPER AVE
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-1401
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Country | US
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Telephone | 480-991-3775
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Fax |
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Provider Business Mailing Address
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Address Line | 6414 E JUNIPER AVE
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-1401
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER/OWNER
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Name | DR. PAUL LAVEN
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Credential | DO
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Telephone | 480-395-1780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2821
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 2821
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License Number State | AZ
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