# ENTICARE PC

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

## Provider details

- **NPI number:** 1821853300
- **Authorized official:** DR. HOMAN MOSTAFAVI (MEMBER MANAGER)
- **Authorized official phone:** (480) 214-9000

## Contact information

- **Practice address:** 17215 N 72ND DR BLDG D, GLENDALE, AZ 85308-8558
- **Practice address phone:** (480) 214-9000
- **Practice address fax:** (480) 214-9999
- **Mailing address:** 2051 W CHANDLER BLVD STE 5, CHANDLER, AZ 85224-6239
- **Mailing address phone:** (480) 214-9000
- **Mailing address fax:** (480) 241-9999

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | NULL | Yes |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/14/2024
- **Last updated:** 02/14/2024