Provider Demographics
NPI:1780989350
Name:SCOTTSDALE GI CONSULTANTS, LLC
Entity type:Organization
Organization Name:SCOTTSDALE GI CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSFI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-247-6777
Mailing Address - Street 1:PO BOX 5508
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85261-5508
Mailing Address - Country:US
Mailing Address - Phone:480-247-6777
Mailing Address - Fax:480-245-7393
Practice Address - Street 1:8060 E GELDING DR
Practice Address - Street 2:SUITE 107
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6960
Practice Address - Country:US
Practice Address - Phone:480-247-6777
Practice Address - Fax:480-245-7393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-12
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29979207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ703109Medicaid
AZF78172Medicare UPIN