ALAN DALE WAMBOLDT (NPI# 1558305540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558305540 |
| Entity Type | Individual |
| Full Name | ALAN DALE WAMBOLDT |
| Credential | M.D. |
| Practice Address |
7525 E Broadway Rd Suite 3 Mesa AZ 85208-2002 |
| Practice Telephone | 4808322097 |
| Practice Fax Number | 4808320530 |
| Mailing Telephone | 4808322097 |
| Mailing Fax Number | 4808320530 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2008-01-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 17046 | AZ | Other Service Providers |
| Street Address |
7525 E BROADWAY RD SUITE 3 |
| City | MESA |
| State | AZ |
| Zip Code | 85208-2002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629073374 | Philip Gabriel Hilcove | Specialist | 7525 E Broadway Rd, Suite 10, Mesa, AZ 85208-2002 | 2005-06-18 |
| 1679020929 | Christopher Crain | Physical Therapist | 7525 E Broadway Rd, Suite 6, Mesa, AZ 85208-2002 | 2016-09-03 |
| 1508259094 | Amita Patel | Physical Therapist | 7525 E Broadway Rd, Suite 6, Mesa, AZ 85208-2002 | 2015-03-09 |
| 1871993659 | On The Mend On The Move Physical Therapy | Physical Therapist | 7525 E Broadway Rd, #6, Mesa, AZ 85208-2002 | 2014-08-28 |
| 1235556184 | Philip G Hilcove Md LLC | Internal Medicine | 7525 E Broadway Rd, Suite 10, Mesa, AZ 85208-2002 | 2014-03-27 |
| 1972857001 | Laura Ruth Starr | Physical Therapist | 7525 E Broadway Rd, Suite 6, Mesa, AZ 85208-2002 | 2012-10-26 |
| 1295968394 | Philip G Hilcove Md LLC | Internal Medicine | 7525 E Broadway Rd, Suite 10, Mesa, AZ 85208-2002 | 2009-08-24 |
| 1649456914 | Martin H Rubin Md Pllc | Internal Medicine | 7525 E Broadway Rd, Suite #1, Mesa, AZ 85208-2002 | 2008-01-16 |
| 1316058936 | Alan D Wamboldt Md Pllc | Orthopaedic Surgery | 7525 E Broadway Rd, Suite 3, Mesa, AZ 85208-2002 | 2006-08-31 |
| 1073522736 | Lloyd D Brenden Md PC | Dermatology | 7525 E Broadway Rd, Suite 10, Mesa, AZ 85208-2002 | 2006-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588203723 | Southwest Cardiovascular Interventional Center, LLC | Clinic/Center | 7529 E Broadway, Mesa, AZ 85208 | 2020-01-06 |
| 1760021802 | Southwest Endovascular Center, LLC | Clinic/Center | 7529 E Broadway Rd, Mesa, AZ 85208 | 2020-01-06 |
| 1083116529 | Hailey Jo Kools | Specialist/Technologist | 11201 N Tatum Boulevard, Phoenix, AZ 85208 | 2018-03-01 |
| 1356881486 | Amber E Anderson | Nurse Practitioner | 1157 S Crismon Rd Ste 101, Mesa, AZ 85208 | 2017-03-08 |
| 1609264464 | Desert House Assisted Living LLC | Assisted Living Facility | 11055 E Grove St, Mesa, AZ 85208 | 2015-01-02 |
| 1366881872 | Freedom Az, LLC | Non-emergency Medical Transport (VAN) | 10682 E Oasis Dr, Mesa, AZ 85208 | 2013-06-18 |
| 1588922884 | Aaron David Hallstrom | Counselor | 158 S Hassett Cir, Mesa, AZ 85208 | 2012-04-25 |
| 1568604593 | David Berrey | Internal Medicine | 1917 South Crismon Rd., Mesa, AZ 85208 | 2009-04-06 |
| 1740475946 | Jackton Simiyu Khausi | Occupational Therapist | 7255 E Broadway, Mesa, AZ 85208 | 2007-09-11 |
| 1881896900 | Kate N Mullowney | Pharmacist | 10238 E Hampton Avenue, Suite 107, Mesa, AZ 85208 | 2007-06-01 |
| Find all providers in zip 85208 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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|---|---|---|---|---|
| 1942810833 | Modern Sports Medicine LLC | Specialist | 6242 E Arbor Ave Unit 1, Mesa, AZ 85206-1309 | 2020-08-05 |
| 1366920910 | Haleys Designer Wigs | Specialist | 6017 E Mckellips Rd Ste 109, Mesa, AZ 85215-2824 | 2018-08-04 |
| 1831604990 | Shanna Kay Parker | Specialist | 1055 W Baseline Rd Apt 1049, Mesa, AZ 85210-9504 | 2017-12-11 |
| 1558884866 | Affiliated Pro Monitoring, LLC | Specialist | 6424 E Broadway Rd Ste 120, Mesa, AZ 85206-1750 | 2017-07-18 |
| 1861863011 | Christina Wright | Specialist | 11033 E Abilene Ave, Mesa, AZ 85208-8645 | 2015-10-14 |
| 1821465584 | Arizona Medical Associates Inc | Specialist | 1301 South Rismon Road, Mesa, AZ 85209-3767 | 2015-08-28 |
| 1174926794 | Breast Ink Plc | Specialist | 2321 S Alta Vista Cir, Mesa, AZ 85202-6474 | 2014-09-28 |
| 1780957985 | Clear Choice Physicians, LLC | Specialist | 6328 E Brown Rd Ste 106, Mesa, AZ 85205-4841 | 2012-02-17 |
| 1538445812 | Modocurogyn, Pllc | Specialist | 6632 E. Baseline Rd, Ste 101, Mesa, AZ 85206 | 2011-10-31 |
| 1508140005 | Janice A Spears | Specialist | 1840 W Emelita Ave, #1144, Mesa, AZ 85202-4035 | 2011-10-03 |
| Find all providers in MESA | ||||
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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.