Individual
ILONA BLEAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8415 N PIMA RD, SUITE 100, SCOTTSDALE, AZ 85258-4480
(480) 661-4761
(480) 661-3990
Mailing address
PO BOX 14390, SCOTTSDALE, AZ 85267-4390
(480) 661-4761
(480) 661-3990
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
AZ1961
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z24030
MEDICARE ID-TYPE UNSPECIFIED
AZ
Enumeration date
08/24/2005
Last updated
02/05/2015
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