Individual
JAMAL D DABBAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2150 S COUNTRY CLUB DR STE 27, MESA, AZ 85210-6860
(623) 252-0881
(602) 313-1914
Mailing address
1840 E WARNER RD STE 120, TEMPE, AZ 85284-3445
(480) 420-6303
(480) 840-1672
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
102L00000X
Psychoanalyst
—
—
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
—
—
133N00000X
Nutritionist
—
—
133V00000X
Registered Dietitian
—
—
171M00000X
Case Manager/Care Coordinator
—
—
207Q00000X
Family Medicine Physician
Primary
51454
AZ
207R00000X
Internal Medicine Physician
51454
AZ
208100000X
Physical Medicine & Rehabilitation Physician
51454
AZ
208D00000X
General Practice Physician
51454
AZ
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
51454
AZ
225C00000X
Rehabilitation Counselor
—
—
225X00000X
Occupational Therapist
51454
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51454
MD LICENSE
AZ
Enumeration date
08/02/2012
Last updated
03/07/2023
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