Organization · NPI-2

Enticare PC

Otolaryngology, Plastic Surgery within the Head & Neck · Glendale, AZ

NPI number1821853300
StatusActive
Last updated in NPPESFeb 14, 2024

Details

NPI
1821853300
Entity type
Organization (NPI-2)
Legal business name
Enticare PC
Organization subpart
No
Enumeration date
Feb 14, 2024
Certification date
Feb 14, 2024
Last updated
Feb 14, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck––Yes

Practice location

17215 N 72nd Dr Bldg D
Glendale, AZ 85308-8558

Phone 480-214-9000 · Fax 480-214-9999

Mailing address

2051 W Chandler Blvd Ste 5
Chandler, AZ 85224-6239

Phone 480-214-9000 · Fax 480-241-9999

Authorized official

Homan Mostafavi
Member Manager
4802149000

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