Organization
ENTICARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOMAN MOSTAFAVI (MEMBER MANAGER)
(480) 214-9000
Entity
Organization
Contact information
Practice address
17215 N 72ND DR BLDG D, GLENDALE, AZ 85308-8558
(480) 214-9000
(480) 214-9999
Mailing address
2051 W CHANDLER BLVD STE 5, CHANDLER, AZ 85224-6239
(480) 214-9000
(480) 241-9999
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
—
—
Other
Enumeration date
02/14/2024
Last updated
02/14/2024
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