Organization
MOUNTAIN VISTA EMERGENCY PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISHA C FALK (VICE PRESIDENT)
(337) 609-1221
Entity
Organization
Contact information
Practice address
5750 E BASELINE RD, MESA, AZ 85206-4806
(602) 833-6900
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
223581
—
AZ
Enumeration date
04/26/2007
Last updated
01/06/2023
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