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DESERT PAIN AND REHAB SPECIALISTS NPI 1457416414


NPI Information

NPI: 1457416414
Provider Name: DESERT PAIN AND REHAB SPECIALISTS
Classification: Physical Medicine & Rehabilitation - 2081P2900X
Entity Type: Organization

Specialization: Pain Medicine

Address:
11047 N 19TH AVE
PHOENIX, AZ
ZIP 85029
Phone: (602) 944-2222
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DESERT PAIN AND REHAB SPECIALISTS is a pain medicine physical medicine rehabilitation in Phoenix, AZ. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. DESERT PAIN AND REHAB SPECIALISTS NPI is 1457416414. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

11047 N 19TH AVE
PHOENIX, AZ
ZIP 85029
Phone: (602) 944-2222
Fax: (602) 331-2499

The provider's authorized official is Herbert Donald Goodman .
The authorized official title is Co-owner and has the following contact phone number (602) 944-2222.

The enumeration date for this NPI number is 12/27/2006 and was last updated on 6/24/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103T00000XPsychologist3984ARIZONANo
2208VP0014XPain MedicineInterventional Pain MedicineNo
3207RA0401XInternal MedicineAddiction Medicine11336ARIZONANo
42081P2900XPhysical Medicine & RehabilitationPain MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1306932MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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