# MESA REGEN GROUP, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1548804800
- **Authorized official:** DR. DEREK PAUL PRUNI DC (MEMBER)
- **Authorized official phone:** (480) 200-7846

## Contact information

- **Practice address:** 5233 E SOUTHERN AVE STE 103, MESA, AZ 85206-3628
- **Practice address phone:** (480) 830-2882
- **Practice address fax:** (480) 830-2881
- **Mailing address:** 5233 E SOUTHERN AVE STE 103, MESA, AZ 85206-3628
- **Mailing address phone:** (480) 830-2882
- **Mailing address fax:** (480) 830-2881

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/30/2019
- **Last updated:** 07/07/2020