Provider Demographics
NPI:1801416011
Name:CONNECTIVE MED, LLC
Entity Type:Organization
Organization Name:CONNECTIVE MED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBASZADEGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-570-2444
Mailing Address - Street 1:825 E ROYAL PALM RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-3749
Mailing Address - Country:US
Mailing Address - Phone:480-652-9952
Mailing Address - Fax:
Practice Address - Street 1:1641 S CARRIAGE LN
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-6711
Practice Address - Country:US
Practice Address - Phone:480-570-2444
Practice Address - Fax:480-907-1125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-17
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty