| CASE NUMBER | I-200-24080-816794 |
| CASE STATUS | Certified |
| RECEIVED DATE | 3/20/2024 |
| DECISION DATE | 3/27/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Hospitalist |
| SOC CODE | 29-1229.02 |
| SOC TITLE | Hospitalists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 7/1/2024 |
| END DATE | 6/30/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Banner University Medical Group |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 2901 N. Central Ave. |
| EMPLOYER ADDRESS2 | Suite #160 |
| EMPLOYER CITY | Phoenix |
| EMPLOYER STATE | AZ |
| EMPLOYER POSTAL CODE | 85012 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 16027477000 |
| EMPLOYER PHONE EXT | |
| 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 ADDRESS1 | 2901 N. Central Ave. |
| EMPLOYER POC ADDRESS2 | Suite # 160 |
| EMPLOYER POC CITY | Phoenix |
| EMPLOYER POC STATE | AZ |
| EMPLOYER POC POSTAL CODE | 85012 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 16027477000 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | yusuf.yaqub@bannerhealth.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Martinez |
| AGENT ATTORNEY FIRST NAME | Matthew |
| AGENT ATTORNEY MIDDLE NAME | J. |
| AGENT ATTORNEY ADDRESS1 | 2929 N. Central Ave. |
| AGENT ATTORNEY ADDRESS2 | Suite # 1700 |
| AGENT ATTORNEY CITY | Phoenix |
| AGENT ATTORNEY STATE | AZ |
| AGENT ATTORNEY POSTAL CODE | 85012 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 16023851040 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | matthew.martinez@lewisbrisbois.com |
| LAWFIRM NAME BUSINESS NAME | Lewis Brisbois Bisgaard & Smith, LLP |
| STATE OF HIGHEST COURT | AZ |
| NAME OF HIGHEST STATE COURT | AZ Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 2800 E. Ajo Way |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Tucson |
| WORKSITE COUNTY | PIMA |
| WORKSITE STATE | AZ |
| WORKSITE POSTAL CODE | 85713 |
| WAGE RATE OF PAY FROM | 244000 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $280,600.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $199,597.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Martinez |
| PREPARER FIRST NAME | Matthew |
| PREPARER MIDDLE INITIAL | J. |
| PREPARER BUSINESS NAME | Lewis Brisbois Bisgaard & Smith, LLP |
| PREPARER EMAIL | matthew.martinez@lewisbrisbois.com |
| BEGIN DATE CONVERTED | 2024-01-07 |
