Organization
LAKE MI MOBILE DOCTORS, P.C.
Active
Other names
Mobile Doctors of Phoenix
Organization subpart
No
Provider details
NPI number
Authorized official
TYSYN CONTRERAS (DIRECTOR, QUALITY ASSURANCE)
(773) 751-7200
Entity
Organization
Contact information
Practice address
2345 E. THOMAS RD, SUITE # 420, PHOENIX, AZ 85016
(602) 955-5700
(602) 955-5701
Mailing address
3319 N ELSTON AVE, SUITE 200, CHICAGO, IL 60618-5811
(773) 751-7200
(773) 583-4401
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
574693
—
AZ
Enumeration date
06/18/2010
Last updated
10/09/2012
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