Provider Demographics
NPI:1215388855
Name:AKDHC, LLC-PHOENIX ACCESS CENTER 1
Entity Type:Organization
Organization Name:AKDHC, LLC-PHOENIX ACCESS CENTER 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADONIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCOBEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-997-0484
Mailing Address - Street 1:3333 E CAMELBACK RD STE 180
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2396
Mailing Address - Country:US
Mailing Address - Phone:602-997-0484
Mailing Address - Fax:602-224-3315
Practice Address - Street 1:9125 W THUNDERBIRD RD STE 105
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4921
Practice Address - Country:US
Practice Address - Phone:623-234-8725
Practice Address - Fax:602-265-4373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty