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General NPI Number Information
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NPI Number | 1750754982
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Entity Type | Organization
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Legal Business Name | CEB CAPITAL LLC
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Dates
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Enumeration Date | 11/10/2015
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 9150 W INDIAN SCHOOL RD SUITE 111B
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City | PHOENIX
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State | AZ
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Zip | 85037-2384
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Country | US
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Telephone | 623-247-2300
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Fax | 623-247-1939
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Provider Business Mailing Address
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Address Line | 9150 W INDIAN SCHOOL RD SUITE 111B
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City | PHOENIX
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State | AZ
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Zip | 85037-2384
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Country | US
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Telephone | 623-247-2300
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Fax | 623-247-1939
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | IVY DORENE JONES
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Credential |
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Telephone | 623-247-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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