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General NPI Number Information
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NPI Number | 1295780799
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Entity Type | Organization
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Legal Business Name | HOPE MEDICAL INSTITUTE INC
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 03/07/2008
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Provider Practice Location Address
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Address Line | 4540 E BASELINE RD SUITE 114
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City | MESA
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State | AZ
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Zip | 85206-4613
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Country | US
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Telephone | 480-633-0294
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Fax | 480-633-0604
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Provider Business Mailing Address
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Address Line | PO BOX 682
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City | GILBERT
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State | AZ
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Zip | 85299-0682
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Country | US
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Telephone | 480-633-0294
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Fax | 480-633-0604
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | DR. PEDRO J MARTINEZ
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Credential | MD
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Telephone | 480-633-0294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 3461
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN082346
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 23489
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License Number State | AZ
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