Provider Demographics
NPI:1740476217
Name:AMIN, MONA S (DO)
Entity type:Individual
Prefix:DR
First Name:MONA
Middle Name:S
Last Name:AMIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:4550 E BELL RD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-9306
Mailing Address - Country:US
Mailing Address - Phone:480-443-8400
Mailing Address - Fax:480-443-8697
Practice Address - Street 1:5681 W BEVERLY LN STE 100
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-9800
Practice Address - Country:US
Practice Address - Phone:480-443-8400
Practice Address - Fax:480-443-8697
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB08315000207RR0500X
AZ5599207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ647263Medicaid
AZZ180824OtherMEDICARE