| LCA CASE NUMBER | I-200-21165-396182 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-06-14 |
| DECISION DATE | 2021-06-22 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Primary Care Physician |
| SOC CODE | 29-1069.00 |
| SOC TITLE | Physicians and Surgeons, All Other |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-09-27 |
| END DATE | 2024-06-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Banner Medical Group |
| EMPLOYER ADDRESS1 | 2901 N. Central Avenue |
| EMPLOYER ADDRESS2 | Suite 160 |
| EMPLOYER CITY | Phoenix |
| EMPLOYER STATE | AZ |
| EMPLOYER POSTAL CODE | 85012 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16027474700 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Yaqub |
| EMPLOYER POC FIRST NAME | Yusuf |
| EMPLOYER POC MIDDLE NAME | M |
| EMPLOYER POC JOB TITLE | Director - HR Shared Services |
| EMPLOYER POC ADDRESS 1 | 2901 N. Central Avenue |
| EMPLOYER POC ADDRESS 2 | Suite 160 |
| EMPLOYER POC CITY | Phoenix |
| EMPLOYER POC STATE | AZ |
| EMPLOYER POC POSTAL CODE | 85012 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16027474000 |
| EMPLOYER POC EMAIL | yusuf.yaqub@bannerhealth.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Martiniez |
| AGENT ATTORNEY FIRST NAME | Matthew |
| AGENT ATTORNEY MIDDLE NAME | J |
| AGENT ATTORNEY ADDRESS1 | 1850 N. Central Ave. |
| AGENT ATTORNEY CITY | Phoenix |
| AGENT ATTORNEY STATE | AZ |
| AGENT ATTORNEY POSTAL CODE | 85004 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16022855056 |
| AGENT ATTORNEY EMAIL ADDRESS | mmartinez@dickinson-wright.com |
| LAWFIRM NAME BUSINESS NAME | Dickinson Wright, PLLC |
| STATE OF HIGHEST COURT | AZ |
| NAME OF HIGHEST STATE COURT | AZ Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 28471 N. Vistancia Blvd. |
| WORKSITE ADDRESS2 | Suite 102 |
| LCA CASE WORKLOC1 CITY | Peoria |
| WORKSITE COUNTY | MARICOPA |
| LCA CASE WORKLOC1 STATE | AZ |
| WORKSITE POSTAL CODE | 85383 |
| LCA CASE WAGE RATE FROM | 190000 |
| LCA CASE WAGE RATE TO | 220000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 173555 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Martinez |
| PREPARER FIRST NAME | Matthew |
| PREPARER MIDDLE INITIAL | J. |
| PREPARER BUSINESS NAME | Dickinson Wright, PLLC |
| PREPARER EMAIL | mmartinez@dickinson-wright.com |
