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General NPI Number Information
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NPI Number | 1043514961
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Entity Type | Organization
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Legal Business Name | JOSEPH A MABILIA D.O. PLLC
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Dates
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Enumeration Date | 01/06/2011
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Last Update Date | 01/06/2011
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Provider Practice Location Address
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Address Line | 3440 W CACTUS RD
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City | PHOENIX
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State | AZ
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Zip | 85029-2238
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Country | US
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Telephone | 602-441-3039
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Fax |
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Provider Business Mailing Address
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Address Line | 10935 E GREENWAY RD
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-1823
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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 | OWNER
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Name | DR. JOSEPH A MABILIA
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Credential | DO
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Telephone | 480-290-1821
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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 | 1684
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License Number State | AZ
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