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

East Valley Infectious Disease Medicine LLC

Organization Infectious Disease Physician · NPI 1508643628

East Valley Infectious Disease Medicine LLC is an Infectious Disease Physician in Mesa, Arizona. Registered with an NPI since 2023.

In the registry since
2023
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

6040 E Main St # 516
Mesa, AZ 85205-8928
Phone: (480) 648-7895
Fax: (623) 552-3320
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Infectious Disease Physician (primary) Taxonomy 207RI0200X

Record details

NPI number1508643628
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shashikala Ameneni — Authorized Signer · (480) 648-7895
NPI enumeratedSeptember 12, 2023
Last updated in NPPESApril 23, 2025
Certification dateApril 23, 2025
Mailing addressEvidm Lockbox Dept 880778, Po Box 29650, Phoenix, AZ 85038-9650

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