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

Genesis Medical Practice Management

Organization Psychologist · NPI 1053657361

Genesis Medical Practice Management is a Psychologist in Phoenix, Arizona. Registered with an NPI since 2012.

In the registry since
2012

Practice location Address checks out

4620 N 16th St E-110
Phoenix, AZ 85016-5121
Phone: (602) 264-2770
Fax: (866) 534-1701
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X

Record details

NPI number1053657361
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Daryl Millar — Ceo · (602) 264-2770
NPI enumeratedDecember 14, 2012
Last updated in NPPESDecember 14, 2012
Mailing address4620 N 16th St, E-110, Phoenix, AZ 85016-5121

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