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General NPI Number Information
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NPI Number | 1598305757
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Entity Type | Organization
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Legal Business Name | MY MYO MY HEALTH, LLC
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Dates
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Enumeration Date | 01/15/2020
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Last Update Date | 01/15/2020
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Provider Practice Location Address
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Address Line | 2155 W PINNACLE PEAK RD STE 201
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City | PHOENIX
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State | AZ
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Zip | 85027-1203
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Country | US
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Telephone | 602-699-5983
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Fax | 480-471-8160
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Provider Business Mailing Address
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Address Line | 2155 W PINNACLE PEAK RD STE 201
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City | PHOENIX
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State | AZ
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Zip | 85027-1203
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Country | US
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Telephone | 602-699-5983
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Fax | 480-471-8160
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | BYRAN DAVID RUBIO
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Credential |
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Telephone | 602-699-5983
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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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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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