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General NPI Number Information
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NPI Number | 1700637196
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Entity Type | Organization
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Legal Business Name | CAMELBACK PHYSICIANS GROUP LLC
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Dates
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Enumeration Date | 04/01/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 4527 N 16TH ST # 201
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City | PHOENIX
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State | AZ
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Zip | 85016-5352
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Country | US
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Telephone | 480-267-0315
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Fax |
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Provider Business Mailing Address
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Address Line | 4527 N 16TH ST # 201
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City | PHOENIX
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State | AZ
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Zip | 85016-5352
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | CHRISTOPHER NEWMAN
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Credential |
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Telephone | 760-835-7562
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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