Provider Demographics
NPI:1952678344
Name:GERINET OF ARIZONA PLC
Entity Type:Organization
Organization Name:GERINET OF ARIZONA PLC
Other - Org Name:HEALTH ESSENTIALS PHYSICIAN GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IYAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-619-8777
Mailing Address - Street 1:6377 E TANQUE VERDE RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3853
Mailing Address - Country:US
Mailing Address - Phone:844-235-6451
Mailing Address - Fax:800-391-4189
Practice Address - Street 1:6377 E TANQUE VERDE RD
Practice Address - Street 2:SUITE 230
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3853
Practice Address - Country:US
Practice Address - Phone:844-235-6451
Practice Address - Fax:800-391-4189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4219207Q00000X
AZ43887207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ152808Medicare Oscar/Certification