NPIMap

Organization Active NPI

East Valley OB/GYN

  • Obstetrics & Gynecology Physician
  • Mesa, AZ
National Provider Identifier
1528209889
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
28517 Issued in AZ
Legal business name
EAST VALLEY OB/GYN
Practice address
1450 S Dobson Rd
Ste. B221
Mesa, AZ 85202-4712
Phone
(480) 461-1161
Fax
(480) 835-1482
NPI assigned
Mar 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lisa Hollar, M.D.
Title
Owner
Phone
(480) 461-1161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 28517 AZ Primary

Addresses

Primary practice location

1450 S Dobson Rd
Ste. B221
Mesa, AZ 85202-4712

Mailing address

1450 S Dobson Rd
Ste. B221
Mesa, AZ 85202-4712
Phone (480) 461-1161

Other identifiers 1

IdentifierTypeStateIssuer
522799MedicaidAZ

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1528209889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 S DOBSON RD",
            "address_2": "STE. B221",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024712",
            "telephone_number": "480-461-1161",
            "fax_number": "480-835-1482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 S DOBSON RD",
            "address_2": "STE. B221",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024712",
            "telephone_number": "480-461-1161",
            "fax_number": "480-835-1482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST VALLEY OB/GYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-17",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "HOLLAR",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-461-1161",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "28517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "522799",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.