Agave Medical Group Pllc

NPI #1033622626 in Mesa, Arizona

Provider Information

NPI Number: 1033622626
Entity Type: Organization
Organization Name: Agave Medical Group Pllc
Primary Specialty: Hospitalist
Enumeration Date: Nov 6, 2017
Last Updated: Nov 6, 2017

Practice Location

Address: 1301 S. CRIMAON RD
City: Mesa
State: Arizona
ZIP Code: 85209-2737
Phone: (480) 219-6631

Authorized Official

Name: RALPH A DISILVA, M.D.
Title: OWNER
Phone: (480) 219-6631

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Hospitalist	208M00000X	Primary

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