Provider Demographics
NPI:1831179019
Name:ALYESH, P.A.
Entity type:Organization
Organization Name:ALYESH, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OMID
Authorized Official - Middle Name:
Authorized Official - Last Name:ALYESHMERNI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:623-849-1736
Mailing Address - Street 1:7333 W THOMAS RD
Mailing Address - Street 2:SUITE 40
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85033-5546
Mailing Address - Country:US
Mailing Address - Phone:623-849-1736
Mailing Address - Fax:623-849-0406
Practice Address - Street 1:7333 W THOMAS RD
Practice Address - Street 2:SUITE 40
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-5546
Practice Address - Country:US
Practice Address - Phone:623-849-1736
Practice Address - Fax:623-849-0406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ61668Medicare ID - Type Unspecified