Provider Demographics
NPI:1891834552
Name:M.B. BEST MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:M.B. BEST MEDICAL GROUP, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LANCHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-303-6737
Mailing Address - Street 1:8618 N 35TH AVE
Mailing Address - Street 2:3
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-3800
Mailing Address - Country:US
Mailing Address - Phone:602-249-0999
Mailing Address - Fax:602-249-6020
Practice Address - Street 1:8618 N 35TH AVE
Practice Address - Street 2:3
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-3800
Practice Address - Country:US
Practice Address - Phone:602-249-0999
Practice Address - Fax:602-249-6020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X, 332B00000X, 332BC3200X
AZ3290363AM0700X
AZ34954207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ237455Medicaid
AZ271924Medicaid
AZ620957OtherAETNA-LEROY KAREUS DO
AZ271924Medicaid
AZ237455Medicaid
AZ365386182Medicare ID - Type UnspecifiedLEROY KAREUS DO