Individual
JOE PANELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
375 NW BEAVER ST STE 101, PRINEVILLE, OR 97754-1802
(520) 643-6627
Mailing address
4948 E DALLAS ST, MESA, AZ 85205-6434
(520) 643-6627
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
7636
AZ
363A00000X
Physician Assistant
7636
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162424
—
AZ
Enumeration date
09/26/2019
Last updated
08/12/2025
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