| NPI | 1265692792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANNET DECARDENAS Billing Manager 480-897-1175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AZ 29615) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2011-09-01 |