Provider Demographics
NPI:1053939066
Name:ACE MEDICAL GROUP LLC
Entity type:Organization
Organization Name:ACE MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZITNIK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-567-5267
Mailing Address - Street 1:5233 E SOUTHERN AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-3628
Mailing Address - Country:US
Mailing Address - Phone:480-888-6675
Mailing Address - Fax:
Practice Address - Street 1:5233 E SOUTHERN AVE STE 104
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-3628
Practice Address - Country:US
Practice Address - Phone:480-567-5267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-07
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty