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Contact Information

CORAESTHETICS PLLC
2008 E LAGUNA DR
TEMPE, AZ85282
 Phone: 480-307-3497
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for CORAESTHETICS PLLC

NPI # 1346741501
LBN Legal business name CORAESTHETICS PLLC
Authorized official JAMIE CORACIDES - (MEMBER MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/23/2018
Last updated 07/09/2018 - About 8 years ago
Identifiers
AZ License # 4462
AZ Other 4462 PHYSICIAN ASSISTANT LICENCE
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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