Longevity Wellness Clinic of Arizona

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

LONGEVITY WELLNESS CLINIC OF ARIZONA

Practice address

3920 S Alma School Rd Ste 8
Chandler, AZ 85248-4511

Phone

(480) 453-1367

NPI assigned

Oct 16, 2019

Organization subpart

No

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

Authorized official

Name

Pamela Robbins

Title

Clinic Director

Phone

(480) 453-1367

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1528600020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10456",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852710456",
            "telephone_number": "480-453-1367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 S ALMA SCHOOL RD STE 8",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852484511",
            "telephone_number": "480-453-1367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGEVITY WELLNESS CLINIC OF ARIZONA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A",
        "authorized_official_last_name": "ROBBINS",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "480-453-1367"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher L Long, DC
• Hongyu Long
• Joni Michelle Long, SLP
• Lizhi Long, RN NMT
• Susan Michele Long, M.S., M.A., CCC-SLP
• James Douglas Loo, M.D.
• Carson D Loose, DPT
• Ana Alicia Lopez, SLPA
• Annette Villalobos Lopez, FNP-C
• Anthony Ramirez Lopez, LMT

• Clinic/Center in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.