Provider Demographics
NPI:1427548916
Name:MESA, AMANDA TOSHIKO MCALISTER (MD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:TOSHIKO MCALISTER
Last Name:MESA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6553 E BAYWOOD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-1753
Mailing Address - Country:US
Mailing Address - Phone:480-543-6750
Mailing Address - Fax:480-543-5907
Practice Address - Street 1:6644 E BAYWOOD AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1797
Practice Address - Country:US
Practice Address - Phone:480-321-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2024-08-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ74073208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery