DR. SOUNDOS K MOUALLA (NPI# 1396853461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396853461 |
| Entity Type | Individual |
| Full Name | DR. SOUNDOS K MOUALLA |
| Credential | MD |
| Practice Address |
802 Ainsworth Dr Ste A Prescott AZ 86301-1623 |
| Mailing Address |
Po Box 10880 Prescott AZ 86304-0880 |
| Practice Telephone | 9284456025 |
| Practice Fax Number | 9287772423 |
| Mailing Telephone | (928) 759-5987 |
| Mailing Fax Number | 9284582039 |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2017-07-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
4301093355 | MI | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
48512 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | ARIZONA LICENSE | 48512 | 01 |
| Street Address |
802 AINSWORTH DR STE A |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86301-1623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114928025 | Jerome C Robinson | Internal Medicine | 802 Ainsworth Dr Ste A, Prescott, AZ 86301-1623 | 2005-08-02 |
| 1649297532 | Carolyn R Kolb | Nurse Practitioner | 802 Ainsworth Dr Ste A, Prescott, AZ 86301-1623 | 2006-07-16 |
| 1356312185 | George Gellert | Anesthesiology | 802 Ainsworth Dr Ste A, Prescott, AZ 86301-1623 | 2006-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102350 | Dove Marie Gundermann | Specialist/Technologist | 300 W. Gurley St, Prescott, AZ 86301 | 2020-07-30 |
| 1639712110 | Arizona Orthopedic Physical Therapy, Pllc | Clinic/Center | 1781 E State Highway 69, Suite 28, Prescott, AZ 86301 | 2019-10-28 |
| 1538714092 | Prescott Complete Care | Family Medicine | 1947 Commerce Center Circle, Suite A, Prescott, AZ 86301 | 2019-08-01 |
| 1336612571 | Sarah Elizabeth Elliott | Registered Nurse | 500 Az 89, Prescott, AZ 86301 | 2019-01-10 |
| 1912484270 | Asya Ruth Perkins | Counselor | 225 Grove Avenue, Prescott, AZ 86301 | 2018-07-19 |
| 1396241394 | Jerome Alexander Longoria | Chiropractor | 142 N. Rush St, Prescott, AZ 86301 | 2018-03-30 |
| 1619487675 | Yavapai Healthcare Group LLC | Nurse Practitioner | 999 Division Street, Prescott, AZ 86301 | 2017-10-04 |
| 1053835843 | United States Veterans Initiative | Counselor | 917 E Gurley St, Prescott, AZ 86301 | 2017-08-02 |
| 1164896999 | Spitler - Lilley, LLC | Hearing Instrument Specialist | 1781 E. State Rte 69, Suite 65, Prescott, AZ 86301 | 2015-11-17 |
| 1275925265 | Oral and Facial Surgery Center of Prescott | Dentist | 5415 Distiction Way, Prescott, AZ 86301 | 2015-02-27 |
| Find all providers in zip 86301 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528394830 | Yavapai Regional Medical Center Physician Care LLC | Internal Medicine | 802 Ainsworth Dr, Suite A, Prescott, AZ 86301-1623 | 2009-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972113546 | Phoenician Cardiac Care LLC | Internal Medicine | 2228 W Northern Ave # D-209, Phoenix, AZ 85021-9369 | 2020-08-07 |
| 1174023584 | Singh Cardiology, Pllc | Internal Medicine | 5170 E Glenn St Ste 130, Tucson, AZ 85712-7300 | 2018-02-13 |
| 1184122434 | Coordinated Health of Az, LLC | Internal Medicine | 2155 W Pinnacle Peak Rd Ste 201c, Phoenix, AZ 85027-1201 | 2018-01-31 |
| 1912405796 | Cardiac Cin of Tucson LLC | Internal Medicine | 5151 E Broadway Blvd Ste 1600a, Tucson, AZ 85711-3777 | 2018-01-26 |
| 1619407442 | Modern Vascular Institute LLC | Internal Medicine | 535 E Mckellips Rd Ste 115, Mesa, AZ 85203 | 2017-06-14 |
| 1578007597 | Rivera Physician Pllc | Internal Medicine | 4345 E Aliso Cyn, Phoenix, AZ 85044-5582 | 2016-12-09 |
| 1841650850 | Cardiac Cath Lab of Phoenix, Lp | Internal Medicine | 1910 E Thomas Rd, Suite 101, Phoenix, AZ 85016-7766 | 2016-03-03 |
| 1770951980 | Evolution Healthcare Management LLC | Internal Medicine | 7615 E Baseline Rd, Suite 101, Mesa, AZ 85209-8520 | 2015-09-03 |
| 1699118240 | Mohammed Tahir Hasoon | Internal Medicine | 9100 N 2nd St Ste 3100, Phoenix, AZ 85020-2446 | 2013-04-14 |
| 1124381637 | Raviinder Mann | Internal Medicine | 3501 N Scottsdale Rd Ste 348, Scottsdale, AZ 85251-5650 | 2012-06-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.