Southwest Sports Medicine & Orthopaedic Surgery Clinic is an orthopedic surgery with a current address of 4566 E. Inverness Rd. Ste. 101 Mesa AZ 8-5206. The NPI is 1083940837, and the license number is 3696 (AZ). It was issued on 10/29/2009. The primary taxonomy code for the clinic is 207X00000X. The provider is registered as an organization, and the NPI number was last updated on 10/29/2009.
Southwest Sports Medicine & Orthopaedic Surgery Clinic can be reached by phone at 4807635950, by mail at 8129 N. 87th Place Scottsdale AZ 8-5258, or by fax at 4807631375.
Angelo Mattalino (Owner) is the authorized representative of the organization and can be reached at this phone number: 4808602618.
Name: Southwest Sports Medicine & Orthopaedic Surgery Clinic
Specialization: Orthopedic Surgery
Provider Entity Type: Organization
Is Organization Subpart: Yes
Authorized Name: Angelo Mattalino
Authorized Title/Position: Owner
Contact Number: 4808602618
Practice Location Address:
4566 E. Inverness Rd. Ste. 101
Telephone Number: 4807635950
Fax Number: 4807631375
8129 N. 87th Place
Telephone Number: 4808602618
Fax Number: 4809983879
NPI is an abbreviation for National Provider Identifier. The NPI is a unique 10-digit identification number. The NPI number does not contain personally identifiable information, such as a provider’s specialty or location. The NPI is assigned to individuals or organizations for their lifetime and is unaffected by updates to key provider information, such as a change in practice, location, or specialty.
NPI Number: 1083940837
Enumeration Date: 10/29/2009
Last Update: 10/29/2009
The NPI record includes the health care provider’s taxonomy classification, state license number, and state of licensure. Health care providers choose their own taxonomy codes. Their specialty is determined by their level of education and training. The taxonomy codes do not indicate what services the healthcare provider provides. The levels of the code set are organized in such a way that it is possible to navigate from the generic classification to the most specific level of specialization of a provider.
Primary Taxonomy Code: 207X00000X
License Number: 3696
License State: AZ
Taxonomy Group: 193400000x Single Specialty Group
Other Taxonomy (if any):
Providers may hold one or more medical licenses in the same state or in different states for different specialties.
Other Identifiers (if any):