Organization
SIP HOME SYSTEMS - MESA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNY MAI (MD)
(623) 374-7774
Entity
Organization
Contact information
Practice address
24TH AT CAMELBACK, 2375 E. CAMELBACK RD., SUITE 600, PHOENIX, AZ 85016
(623) 374-7774
Mailing address
24TH AT CAMELBACK, 2375 E. CAMELBACK RD., SUITE 600, PHOENIX, AZ 85016-2111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
251E00000X
Home Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
=========
—
AZ
Enumeration date
01/29/2020
Last updated
04/30/2020
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