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General NPI Number Information
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NPI Number | 1881351856
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Entity Type | Organization
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Legal Business Name | HIDDEN PEAKS LLC
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Dates
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Enumeration Date | 11/24/2021
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Last Update Date | 11/24/2021
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Provider Practice Location Address
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Address Line | 15255 NORTH 40 ST SUITE 119
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City | PHOENIX
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State | AZ
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Zip | 85032
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Country | US
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Telephone | 602-558-9259
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Fax |
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Provider Business Mailing Address
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Address Line | 7000 N 16TH ST STE 120
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City | PHOENIX
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State | AZ
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Zip | 85020-5524
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Country | US
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Telephone | 602-558-9259
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMBER SCOTT
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Credential |
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Telephone | 602-558-9259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083C0008X
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Taxonomy Name | Clinical Informatics Physician
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License Number |
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License Number State |
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