# INSTITUTE FOR MALE HEALTH&PERFORMANCE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** INSTITUTE FOR MALE HEALTH&PERFORMANCE LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609359983
- **Authorized official:** DR. ESSA SIDIQI MD (OWNER)
- **Authorized official phone:** (928) 453-0777

## Contact information

- **Practice address:** 1830 MESQUITE AVE STE B, LAKE HAVASU CITY, AZ 86403-5885
- **Practice address phone:** (928) 453-0777
- **Practice address fax:** (928) 453-0778
- **Mailing address:** 1990 MCCULLOCH BLVD N \# D230, LAKE HAVASU CITY, AZ 86403-5749
- **Mailing address phone:** (928) 453-0777
- **Mailing address fax:** (928) 453-0778

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/12/2018
- **Last updated:** 09/12/2018