Provider Demographics
NPI:1386705234
Name:ARIZONA SKINCARE PHYSICIANS, PLC
Entity type:Organization
Organization Name:ARIZONA SKINCARE PHYSICIANS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-991-3203
Mailing Address - Street 1:10565 N TATUM BLVD
Mailing Address - Street 2:SUITE B-116
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-1095
Mailing Address - Country:US
Mailing Address - Phone:480-991-3203
Mailing Address - Fax:480-991-3997
Practice Address - Street 1:10565 N TATUM BLVD
Practice Address - Street 2:SUITE B-116
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-1095
Practice Address - Country:US
Practice Address - Phone:480-991-3203
Practice Address - Fax:480-991-3997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z69279Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER