Provider Demographics
NPI:1083047518
Name:HONORHEALTH AMBULATORY
Entity type:Organization
Organization Name:HONORHEALTH AMBULATORY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-587-5123
Mailing Address - Street 1:PO BOX 845635
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90084-5635
Mailing Address - Country:US
Mailing Address - Phone:623-434-6200
Mailing Address - Fax:
Practice Address - Street 1:1124 E MCKELLIPS RD
Practice Address - Street 2:SUITE 110
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-2783
Practice Address - Country:US
Practice Address - Phone:480-882-7370
Practice Address - Fax:480-649-2832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-20
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZPENDINGMedicare PIN