PINETOP-LAKESIDE INTEGRATIVE & PHYSICAL MEDICINE,LLC
NPI 1376864462
Physical Medicine & Rehabilitation - Pain Medicine in Lakeside, AZ

Q: What is Pinetop-Lakeside Integrative & Physical Medicine,llc's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Pain Medicine, with taxonomy code 2081P2900X.

Active since June 13, 2010

1628 REED LN, LAKESIDE, AZ 85929(928) 358-1648(928) 368-5178 Get Directions Write a Review

NPPES record last updated: June 13, 2010. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Pinetop-lakeside Integrative & Physical Medicine,llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PINETOP-LAKESIDE INTEGRATIVE & PHYSICAL MEDICINE,LLC (NPI 1376864462) is a healthcare organization registered as a pain medicine in Lakeside, Arizona and active in the NPI registry since June 2010. The organization lists Kevin Mar, Manager, as its authorized official.

NPPES Registry Identity

NPI1376864462

Entity TypeOrganization

Primary Taxonomy2081P2900X

Legal Business NamePINETOP-LAKESIDE INTEGRATIVE & PHYSICAL MEDICINE,LLC

Location Address1628 REED LNLakeside, AZ 85929-6983

Mailing Address1628 Reed LnLakeside, AZ 85929-6983 · (928) 358-1648

Phone(928) 358-1648

Fax(928) 368-5178

Organization SubpartNo

Authorized OfficialKevin MarManager · (928) 358-1648

Enumeration DateJune 13, 2010

✔ NPI 1376864462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2081P2900X

License✔ Licensed in AZ · 34673

Definition

A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.

Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X · License 34673 (AZ)

1628 REED LN, Lakeside, AZ 85929

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pinetop-Lakeside Integrative & Physical Medicine,llc's NPI number?

The NPI number for Pinetop-Lakeside Integrative & Physical Medicine,llc is 1376864462. It was assigned to this organization in the NPPES registry on June 13, 2010.

Where is Pinetop-Lakeside Integrative & Physical Medicine,llc located?

Pinetop-Lakeside Integrative & Physical Medicine,llc is located at 1628 Reed Ln, Lakeside, AZ 85929. The listed phone number is (928) 358-1648.

What is Pinetop-Lakeside Integrative & Physical Medicine,llc's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Pain Medicine, with taxonomy code 2081P2900X.

When was this NPI record last updated?

The NPPES record for Pinetop-Lakeside Integrative & Physical Medicine,llc was last updated on June 13, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.