Provider Demographics
NPI:1669942793
Name:ISAKOVA, ESTHER
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:ISAKOVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20401 N 73RD ST STE 230
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4153
Mailing Address - Country:US
Mailing Address - Phone:805-560-4464
Mailing Address - Fax:623-209-7669
Practice Address - Street 1:19646 N 27TH AVE STE 305
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4027
Practice Address - Country:US
Practice Address - Phone:805-560-4464
Practice Address - Fax:623-209-7669
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-02
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7427363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty