Basic Information
Provider Information
NPI: 1659764884
EntityType: 2
ReplacementNPI:  
OrganizationName: AKDHC, LLC
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Mailing Information
Address1: 3333 E CAMELBACK RD
Address2: SUITE 180
City: PHOENIX
State: AZ
PostalCode: 850182322
CountryCode: US
TelephoneNumber: 6029970484
FaxNumber: 6022243315
Practice Location
Address1: 7301 E 2ND ST
Address2: SUITE 118
City: SCOTTSDALE
State: AZ
PostalCode: 852515600
CountryCode: US
TelephoneNumber: 4809941238
FaxNumber: 4809949649
Other Information
ProviderEnumerationDate: 03/12/2015
LastUpdateDate: 07/21/2022
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AuthorizedOfficialLastName: ESCOBEDO
AuthorizedOfficialFirstName: ADONIS
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AuthorizedOfficialTitleorPosition: CREDENTIALING MANAGER
AuthorizedOfficialTelephone: 6027596883
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MS.
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RN0300X AZY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineNephrology

No ID Information.


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