28TH Street Medical Group, LLC
Organization Active NPI General Practice Physician · Phoenix, AZ
NPI 1447723598 · NPPES record last updated Jan 5, 2023
Key facts
- NPI
- 1447723598
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- 28TH STREET MEDICAL GROUP, LLC
- Practice address
- 2836 E Indian School Rd Ste A8
Phoenix, AZ 85016-6864 - Phone
- (602) 840-0056
- Fax
- (480) 926-2260
- NPI assigned
- Jan 10, 2019
- Organization subpart
- No
Authorized official
- Name
- Radman Rahiminejad
- Title
- Owner
- Phone
- (480) 926-7800
National Provider Directory
Locations
2836 E Indian School Rd
Ste A8
Phoenix, AZ 85016
Phone (602) 840-0056
2824 E Indian School Rd
Ste 5
Phoenix, AZ 85016
Phone (602) 840-0056
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | |||
| Physical Medicine & Rehabilitation Physician |
208100000X | |||
| General Practice Physician |
208D00000X | Yes | ||
| Physical Therapist |
225100000X | |||
| Physician Assistant |
363A00000X |
Addresses
Primary practice location
2836 E Indian School Rd Ste A8
Phoenix, AZ 85016-6864
Mailing address
PO Box 6610
Chandler, AZ 85246-6610
Phone (480) 926-7800
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2023. 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.