=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114842663
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADONIS JABBOUR INFECTIOUS DISEASE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2026
-----------------------------------------------------
Last Update Date | 08/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6644 E BAYWOOD AVE
-----------------------------------------------------
City | MESA
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85206-1797
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-223-0110
-----------------------------------------------------
Fax | 714-223-0115
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 10936
-----------------------------------------------------
City | TEMPE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85284-0016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-223-0110
-----------------------------------------------------
Fax | 714-223-0115
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CONTRACTING ADMIN
-----------------------------------------------------
Name | LINDA MAYS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 714-223-0110
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208M00000X
-----------------------------------------------------
Taxonomy Name | Hospitalist Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------