MEDICARE: PAIN SPECIALISTS OF ARIZONA LLC

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
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician

General Provider Information

NPI Number	:	1700408960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAIN SPECIALISTS OF ARIZONA LLC

Provider Business Mailing Address
First Line	:	4727 E BELL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2308
Country	:	US
Telephone Number	:	480-515-9444
Fax Number	:

Provider Business Practice Location Address
First Line	:	4727 E BELL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2308
Country	:	US
Telephone Number	:	480-515-9444
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PARTNER
Name	:	DR. JIN YUK
Credential	:	MD
Telephone Number	:	480-515-9444

Provider Enumeration Date	:	05/11/2020
Last Update Date	:	05/11/2020

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