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General NPI Number Information
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NPI Number | 1326098005
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Entity Type | Organization
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Legal Business Name | SJHMC PHYSICIAN SERVICES
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 03/10/2023
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Provider Practice Location Address
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Address Line | 350 W THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85013-4409
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Country | US
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Telephone | 602-406-3729
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Fax | 602-798-9412
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Provider Business Mailing Address
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Address Line | FILE 56765
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City | LOS ANGELES
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State | CA
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Zip | 90074-0001
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Country | US
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Telephone | 602-406-4596
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Fax | 602-798-9655
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | JEFFREY JACKSON
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Credential |
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Telephone | 602-406-4618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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