| Sozo Lifestyle Medicine Pllc | |
|
10045 E Dynamite Blvd Ste F130 Scottsdale AZ 85262-3746 | |
| (480) 404-4346 | |
| (480) 781-0020 |
| Full Name | Sozo Lifestyle Medicine Pllc |
|---|---|
| Speciality | General Practice |
| Location | 10045 E Dynamite Blvd Ste F130, Scottsdale, Arizona |
| Authorized Official Name and Position | Mary Elizabeth Young (PHYSICIAN/OWNER) |
| Authorized Official Contact | 6025709441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sozo Lifestyle Medicine Pllc 10045 E Dynamite Blvd Ste F130 Scottsdale AZ 85262-3746 Ph: (804) 404-4346 | Sozo Lifestyle Medicine Pllc 10045 E Dynamite Blvd Ste F130 Scottsdale AZ 85262-3746 Ph: (480) 404-4346 |
| NPI Number | 1669205795 |
|---|---|
| Provider Enumeration Date | 08/23/2024 |
| Last Update Date | 08/23/2024 |
| Medicare PECOS PAC ID | 3678008398 |
|---|---|
| Medicare Enrollment ID | O20241119000378 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669205795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Mary E Young |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447415427 PECOS PAC ID: 7618035205 Enrollment ID: I20081126000041 |
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