| NPI | 1114611837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVIE VOSOUGH Senior Managed Care Specialist 480-716-5820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2023-06-06 |
| Last Update Date | 2023-06-06 |