NPI 1033622626

Agave Medical Group PLLC

Organisation Hospitalist Physician Mesa, AZ

Practice location

Address: 1301 S. Crimaon Rd, Mesa, AZ 85209-2737
Phone: (480) 219-6631
Fax: (480) 247-3251
Mailing address: 2925 East Riggs Rd Suite 8 Pmb 179, Chandler, AZ 85249-3600

Authorised official

Name: Ralph a Disilva
Title: Owner
Phone: (480) 219-6631

Registered specialties

Hospitalist Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208M00000X Licence 36884 (AZ)

Other Hospitalist providers in Arizona →

Registry record

NPI: 1033622626
Entity type: Organization
NPI issued: 6 Nov 2017
Record last updated: 6 Nov 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.