| Interventional Psychiatry Of Arizona | |
|
2122 E Highland Ave Ste 335 Phoenix AZ 85016-4760 | |
| (602) 824-8404 | |
| (602) 899-6550 |
| Full Name | Interventional Psychiatry Of Arizona |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2122 E Highland Ave Ste 335, Phoenix, Arizona |
| Authorized Official Name and Position | Gerhard Francois Gomez (CEO) |
| Authorized Official Contact | 6028248404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Interventional Psychiatry Of Arizona Po Box 10261 Phoenix AZ 85064-0261 Ph: (602) 824-8404 | Interventional Psychiatry Of Arizona 2122 E Highland Ave Ste 335 Phoenix AZ 85016-4760 Ph: (602) 824-8404 |
| NPI Number | 1215474101 |
|---|---|
| Provider Enumeration Date | 01/30/2017 |
| Last Update Date | 02/14/2024 |
| Certification Date | 02/14/2024 |
| Medicare PECOS PAC ID | 5496030355 |
|---|---|
| Medicare Enrollment ID | O20170316001504 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215474101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 49791 (Arizona) | Primary |
| Provider Name | Nina A Gomez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376977934 PECOS PAC ID: 8123253507 Enrollment ID: I20131022000231 |
| Provider Name | Gerhard F Gomez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760611677 PECOS PAC ID: 4789802109 Enrollment ID: I20160112000034 |
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