Phoenix Id Llc

LBN: Phoenix Id Llc
Phoenix Id Llc is an health care organization with primary practice located at 340 E Palm Ln Ste 100 , Phoenix AZ 85004-4528. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as the primary health care specialty. Phoenix Id Llc can be contacted via phone (602) 254-1136, or through Oommen, Jacob via phone (480) 907-7786.

Contact Information

Primary practice address
340 E Palm Ln Ste 100 Phoenix AZ 85004-4528
Phone: (602) 254-1136
Fax: (602) 272-1720
Website:
Map and Directions
Authorized official contact:
Name: Oommen, Jacob Doctor of Medicine (MD)
Phone: (480) 907-7786

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 37316 Arizona

Profile Details

NPI number 1205027646
LBN Legal business name Phoenix Id Llc
DBA Doing business as
Authorized official Oommen, Jacob Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 8th, 2007
Last updated Oct 9th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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