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Individual

MOSTAFA MAITA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2121 S MILL AVE STE 101, TEMPE, AZ 85282-2106
(602) 853-4004
Mailing address
2121 S MILL AVE STE 101, TEMPE, AZ 85282-2106
(602) 853-4004

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
008885
AZ
208VP0014X
Interventional Pain Medicine Physician
Primary
008885
AZ
208VP0014X
Interventional Pain Medicine Physician
T9177
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
008885
LICENSE
AZ
01
091340
AHCCCS
AZ
01
T9177
LICENSE
TX
Enumeration date
04/11/2017
Last updated
01/06/2026
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