| NPI | 1073094660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GANESH ACHARYA Authorized Official 602-370-0721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2020-04-05 |