Provider Demographics
NPI:1841473139
Name:JOE HAYASHI, PC
Entity type:Organization
Organization Name:JOE HAYASHI, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:T
Authorized Official - Last Name:HAYASHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-546-6535
Mailing Address - Street 1:14300 W GRANITE VALLEY DR
Mailing Address - Street 2:STE D18
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-5783
Mailing Address - Country:US
Mailing Address - Phone:623-546-6535
Mailing Address - Fax:623-546-6824
Practice Address - Street 1:14300 W GRANITE VALLEY DR
Practice Address - Street 2:STE D18
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5783
Practice Address - Country:US
Practice Address - Phone:623-546-6535
Practice Address - Fax:623-546-6824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12865207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ71076OtherMEDICARE INDIVIDUAL PROV#
AZ297285Medicaid
AZ297285Medicaid
D36998Medicare UPIN