Provider Demographics
NPI:1316340953
Name:DOC LIPAN PLLC
Entity type:Organization
Organization Name:DOC LIPAN PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-457-7300
Mailing Address - Street 1:PO BOX 15515
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85267
Mailing Address - Country:US
Mailing Address - Phone:480-323-0588
Mailing Address - Fax:480-821-9555
Practice Address - Street 1:3811 E. BELL RD
Practice Address - Street 2:STE 103
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032
Practice Address - Country:US
Practice Address - Phone:480-323-0588
Practice Address - Fax:480-333-5163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-26
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21830284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital