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General NPI Number Information
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NPI Number | 1477379964
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Entity Type | Organization
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Legal Business Name | AZ MOBILE HEALTH LLC
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Dates
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Enumeration Date | 11/29/2024
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Last Update Date | 01/26/2025
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Provider Practice Location Address
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Address Line | 101 N 1ST AVE STE 2325
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City | PHOENIX
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State | AZ
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Zip | 85003-1933
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Country | US
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Telephone | 602-518-5866
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Fax | 480-718-8857
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Provider Business Mailing Address
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Address Line | 4111 N 21ST ST APT 120
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City | PHOENIX
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State | AZ
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Zip | 85016-6164
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Country | US
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Telephone | 602-577-1256
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SETH D HANSON
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Credential | PA-C
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Telephone | 602-577-1256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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