Organization
PHYSICIAN PAY GROUP LLC
Active
Other names
PHYSICIAN PAY GROUP LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ALI-ANDRA OTTUN (CEO)
(480) 321-6627
Entity
Organization
Contact information
Practice address
9002 N CENTRAL AVE, PHOENIX, AZ 85020-2405
(480) 321-6627
Mailing address
4241 N 23RD AVE APT 3, PHOENIX, AZ 85015-7006
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
—
163WC0400X
Case Management Registered Nurse
—
—
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
—
—
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
—
—
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
364SP0810X
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
—
—
405300000X
Prevention Professional
—
—
Other
Enumeration date
07/31/2025
Last updated
08/01/2025
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