NPIMap

Organization Active NPI

Arizona Medical Clinic University Drive, LLC

Doing business as Arizona Medical Clinic

  • Family Medicine Physician
  • Mesa, AZ
National Provider Identifier
1588429765
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ARIZONA MEDICAL CLINIC UNIVERSITY DRIVE, LLC
Doing business as
Arizona Medical Clinic
Practice address
761 E University Dr Ste 101
Mesa, AZ 85203-7961
Phone
(480) 508-6712
Fax
(480) 572-1085
NPI assigned
Feb 16, 2024
Last updated
Feb 16, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
EPANGELIA PROPERTIES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Authorized official

Name
Linda Som, MDNPI 1477511764
Title
VP
Phone
(602) 274-2100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

761 E University Dr Ste 101
Mesa, AZ 85203-7961

Mailing address

1847 W Heatherbrae Dr
Phoenix, AZ 85015-4764
Phone (602) 274-2100

Other names 1

  • Arizona Medical Clinic Doing business as

National Provider Directory

National Provider Directory
Part of
Epangelia Properties LLC

Locations

761 E University Dr
Ste 101
Mesa, AZ 85203
Phone (480) 508-6712

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708041600000",
    "number": "1588429765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1847 W HEATHERBRAE DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850154764",
            "telephone_number": "602-274-2100",
            "fax_number": "602-535-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 E UNIVERSITY DR STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852037961",
            "telephone_number": "480-508-6712",
            "fax_number": "480-572-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA MEDICAL CLINIC UNIVERSITY DRIVE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EPANGELIA PROPERTIES, LLC",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A",
        "authorized_official_last_name": "SOM",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "602-274-2100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arizona Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 16, 2024; 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.