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NPI Code Detail

MEDICARE: NBBA

MEDICARE: NBBA
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
1261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1336029925
Entity Type Code : Organization
Provider Name (Legal Business Name) : NBBA
Provider Business Mailing Address
First Line : 10210 N 92ND ST STE 104
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85258-4531
Country : US
Telephone Number : 480-493-0900
Fax Number :
Provider Business Practice Location Address
First Line : 1560 BROADWAY STE 1600
Second Line :
City : DENVER
State : CO
Zip : 80202-5160
Country : US
Telephone Number : 480-493-0900
Fax Number :
Authorized Official
Title or Position : OWNER
Name : BRITTANY TREVINO-GOMBAR
Credential : FNP
Telephone Number : 623-295-1190
Provider Enumeration Date : 09/04/2025
Last Update Date : 09/04/2025

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Directions to “NBBA ” Practice Location

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