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

Mesa Physician Group

Organization General Practice Physician · NPI 1104447788

Mesa Physician Group is a General Practice Physician in Mesa, Arizona. Registered with an NPI since 2020.

In the registry since
2020

Practice location Address checks out

5151 E Broadway Rd Ste 105
Mesa, AZ 85206-1346
Phone: (480) 809-6587
Show map & directions

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

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1104447788
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeremiah Faber — Ceo · (480) 258-3635
NPI enumeratedMay 5, 2020
Last updated in NPPESMay 6, 2020
Certification dateMay 6, 2020
Mailing addressPo Box 964, Gilbert, AZ 85299-0964

Other providers in Mesa