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Contact Information

DESERT PAIN AND REHAB SPECIALISTS
11047 N 19TH AVE
PHOENIX, AZ85029
 Phone: 602-944-2222
 Fax: 602-331-2499
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
 

Addiction Medicine

207RA0401X 11 Physician/Internal Medicine
 

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for DESERT PAIN AND REHAB SPECIALISTS · (Female)

NPI # 1457416414
Status Active
Credentials
Entity Individual
Enumeration date 12/27/2006
Last updated 06/24/2019 - About 7 years ago
Sole proprietor 1 Not specified
Identifiers
  • AZ License # 11336
  • AZ License # 3984
  • AZ Medicaid 306932
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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