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Organization
INSTITUTE FOR MALE HEALTH&PERFORMANCE LLC
Active
Organization
INSTITUTE FOR MALE HEALTH&PERFORMANCE LLC
Active
Other names
INSTITUTE FOR MALE HEALTH&PERFORMANCE LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ESSA SIDIQI MD (OWNER)
(928) 453-0777
Entity
Organization
Contact information
Practice address
1830 MESQUITE AVE STE B, LAKE HAVASU CITY, AZ 86403-5885
(928) 453-0777
(928) 453-0778
Mailing address
1990 MCCULLOCH BLVD N # D230, LAKE HAVASU CITY, AZ 86403-5749
(928) 453-0777
(928) 453-0778
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/12/2018
Last updated
09/12/2018
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