Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Vitality Internal Medicine - Phoenix PLLC

Organization Primary Care Clinic/Center · NPI 1407200868

Vitality Internal Medicine - Phoenix PLLC is a Primary Care Clinic/Center in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2016.

Licensed in
AZ
In the registry since
2016
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4643 N 12th St Ste 101
Phoenix, AZ 85014-4006
Phone: (602) 626-8986
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X · Licence 37616 (AZ)

Record details

NPI number1407200868
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charles Evans — Owner · (602) 791-9112
NPI enumeratedApril 21, 2016
Last updated in NPPESApril 21, 2016
Mailing address8776 E Shea Blvd, Ste B3a-129, Scottsdale, AZ 85260-6629

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