Provider Demographics
NPI:1376388199
Name:UMPC PLLC
Entity type:Organization
Organization Name:UMPC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JARVINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-448-9990
Mailing Address - Street 1:2163 E BASELINE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1541
Mailing Address - Country:US
Mailing Address - Phone:480-448-9990
Mailing Address - Fax:
Practice Address - Street 1:10238 E HAMPTON AVE STE 411
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-3320
Practice Address - Country:US
Practice Address - Phone:480-943-1220
Practice Address - Fax:480-943-1229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty