Organization
WESTERN MED GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS MOSHIRI (MANAGER)
(602) 441-3573
Entity
Organization
Contact information
Practice address
7558 W THUNDERBIRD RD STE 4B, PEORIA, AZ 85381-6080
(623) 412-2241
Mailing address
21001 N TATUM BLVD STE 1630-606, PHOENIX, AZ 85050-4242
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
02/04/2021
Last updated
02/24/2022
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