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General NPI Number Information
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NPI Number | 1184913659
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Entity Type | Individual
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Provider Name | AMIRARSALAN EISSA M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 06/15/2025
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Provider Practice Location Address
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Address Line | 1209 S 1ST AVE
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City | PHOENIX
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State | AZ
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Zip | 85003-2692
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Country | US
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Telephone | 602-258-6797
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Fax | 602-248-8113
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Provider Business Mailing Address
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Address Line | 3877 N 7TH ST STE 400
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City | PHOENIX
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State | AZ
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Zip | 85014-5061
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Country | US
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Telephone | 602-258-6797
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 50946
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | 50946
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License Number State | AZ
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