Provider Demographics
NPI:1932406105
Name:EAST VALLEY PULMONARY ASSOCIATES
Entity Type:Organization
Organization Name:EAST VALLEY PULMONARY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:M FIRAS
Authorized Official - Middle Name:
Authorized Official - Last Name:JOUDEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-626-8737
Mailing Address - Street 1:PO BOX 42050
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85274-2050
Mailing Address - Country:US
Mailing Address - Phone:480-626-8737
Mailing Address - Fax:
Practice Address - Street 1:2600 E SOUTHERN AVE
Practice Address - Street 2:STE I-3
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7610
Practice Address - Country:US
Practice Address - Phone:480-626-8737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-23
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32258207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty