Active Lifestyle Medical PC
Organization Active NPI Clinic/Center · Scottsdale, AZ
NPI 1013970334 · NPPES record last updated Feb 8, 2015
Key facts
- NPI
- 1013970334
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- License
- 000000000928481 (AZ)
- Legal business name
- ACTIVE LIFESTYLE MEDICAL PC
- Practice address
- 9449 N 90TH St
Ste 114
Scottsdale, AZ 85258-5099 - Phone
- (480) 860-0300
- Fax
- (480) 422-4321
- NPI assigned
- Apr 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Thomas L Tinlin, DC
- Title
- President Senior Clinician
- Phone
- (480) 860-0300
Practitioners 6
-
Michael Robert Compton, FNP-C, D.C.
-
Candice M Gaitanis, CFNP, ARNP
-
Drew Anthony Durbin, D.O.
-
Grant McKernan, N.M.D.
-
Eddie M Lipan, MD
National Provider Directory
Locations
10752 N 89th Pl
Ste C128
Scottsdale, AZ 85260
Phone (480) 247-9190
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 000000000928481 | AZ | Yes |
Addresses
Primary practice location
9449 N 90TH St
Ste 114
Scottsdale, AZ 85258-5099
Mailing address
9449 N 90TH St
Ste 114
Scottsdale, AZ 85258-5099
Phone (480) 860-0300
Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.