# DESERT PAIN AND REHAB SPECIALISTS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457416414
- **Authorized official:** MR. HERBERT DONALD GOODMAN M.D. (CO-OWNER)
- **Authorized official phone:** (602) 944-2222

## Contact information

- **Practice address:** 11047 N 19TH AVE, PHOENIX, AZ 85029
- **Practice address phone:** (602) 944-2222
- **Practice address fax:** (602) 331-2499
- **Mailing address:** 11047 N 19TH AVE, PHOENIX, AZ 85029-4816
- **Mailing address phone:** (602) 944-2222
- **Mailing address fax:** (602) 331-2499

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | 3984 | AZ | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | 11336 | AZ | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 12/27/2006
- **Last updated:** 06/24/2019