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NPI Code Detail

MEDICARE: DR. JOANNA NGUYEN ISRAEL D.O.

MEDICARE:  DR. JOANNA NGUYEN ISRAEL  D.O.
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
1208100000XPhysical Medicine & Rehabilitation Physician009074AZ

General Provider Information

NPI Number : 1710412655
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOANNA NGUYEN ISRAEL D.O.
Provider Business Mailing Address
First Line : 10645 N TATUM BLVD # 200-564
Second Line :
City : PHOENIX
State : AZ
Zip : 85028-3068
Country : US
Telephone Number : 480-947-7712
Fax Number :
Provider Business Practice Location Address
First Line : 8850 E PIMA CENTER PKWY
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85258-4619
Country : US
Telephone Number : 480-947-7712
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2017
Last Update Date : 04/23/2024

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