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NPI Code Detail

MEDICARE: DR. DAVID RALPH ENGSTROM PH.D.

MEDICARE: DR. DAVID RALPH ENGSTROM PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TB0200XCognitive & Behavioral Psychologist2048AZ

General Provider Information

NPI Number : 1194850248
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID RALPH ENGSTROM PH.D.
Provider Business Mailing Address
First Line : 10059 E CINNABAR AVE
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85258-4802
Country : US
Telephone Number : 480-443-3332
Fax Number : 480-922-5569
Provider Business Practice Location Address
First Line : 9832 N HAYDEN RD
Second Line : SUITE 106
City : SCOTTSDALE
State : AZ
Zip : 85258-1298
Country : US
Telephone Number : 480-443-3332
Fax Number : 480-922-5569
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 07/08/2007

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