Provider Demographics
NPI:1508378274
Name:L & S AZ L.L.C.
Entity Type:Organization
Organization Name:L & S AZ L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:AWAD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-219-6631
Mailing Address - Street 1:201 W. GUADALUPE RD #102
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233
Mailing Address - Country:US
Mailing Address - Phone:480-219-6631
Mailing Address - Fax:480-247-3251
Practice Address - Street 1:201 W. GUADALUPE RD #102
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233
Practice Address - Country:US
Practice Address - Phone:480-219-6631
Practice Address - Fax:480-247-3251
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:L & S AZ L.L.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty