| NPI | 1154745263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFFORD T BAKER Owner 623-777-4747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: AZ 42990) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 42990) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: AZ 42990) | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: AZ 42990) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: AZ 42990) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AZ 42990) | |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2024-02-19 |