Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

East Southern Medical Group, LLC

Organization Physical Medicine & Rehabilitation Physician · NPI 1477011237

East Southern Medical Group, LLC is a Physical Medicine & Rehabilitation Physician in Mesa, Arizona. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5233 E Southern Ave Ste 103
Mesa, AZ 85206-3628
Phone: (480) 830-2882
Fax: (480) 830-2881
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X

Record details

NPI number1477011237
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Derek Pruni — Owner · (480) 830-2882
NPI enumeratedMarch 11, 2019
Last updated in NPPESMay 2, 2023
Certification dateMay 2, 2023
Mailing address5233 E Southern Ave Ste 103, Mesa, AZ 85206-3628

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