| NPI | 1083783724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNARDO O TAN Physician 602-471-6521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: AZ 32141) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2011-01-11 |