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Contact Information

OBL
14804 N CAVE CREEK RD STE 200
PHOENIX, AZ85032-4945
 Phone: 480-240-5613
 Fax: 480-205-1063
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Integrative Medicine

202D00000X
 

Community/Behavioral Health

251S00000X
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for OBL

NPI Number 1508430661
LBN Legal business name OBL
Authorized official KIUP KIM - (FOUNDER / CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 05/13/2021
Last updated 05/04/2023 - About 3 years ago
Identifiers
AZ Medicaid 92926
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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