| NPI | 1194212977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES BENJAMIN EVANS Medical Director 602-791-9112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2023-03-07 |