San Tan Mobile Diagnostics LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

SAN TAN MOBILE DIAGNOSTICS LLC

Practice address

1457 W Southern Ave
Suite 24
Mesa, AZ 85202-4813

Phone

(928) 362-0979

Fax

(480) 999-5641

NPI assigned

Jan 13, 2015

Organization subpart

No

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

Authorized official

Name

Garrett Lubben

Title

President

Phone

(928) 362-0979

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1982093076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1457 W SOUTHERN AVE",
            "address_2": "SUITE 24",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024813",
            "telephone_number": "928-362-0979",
            "fax_number": "480-999-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1457 W SOUTHERN AVE",
            "address_2": "SUITE 24",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024813",
            "telephone_number": "928-362-0979",
            "fax_number": "480-999-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN TAN MOBILE DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-13",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "LUBBEN",
        "authorized_official_first_name": "GARRETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-362-0979"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• India Samuels
• Delaney Samuelson
• San Tan Behavioral Health SVCS
• San Tan Cardiovascular Center LLC
• San Tan Internal Medicine, PLLC
• San Tan Psychiatry PLLC
• Sana Physical Therapy, LLC
• Amelia Joy Sanborn, RN
• Edna M. Sanches Goncalvez
• Katie Shandel Sanchez Amaya

• Physiological Laboratory in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physiological Laboratory in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.