| NPI | 1295056919 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KIUP ALEX KIM Manager 480-299-7654 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 208600000X Surgery | 
| Additional Taxonomies | 207Q00000X Family Medicine | 
| 207QA0505X Family Medicine, Adult Medicine | |
| 207QB0002X Family Medicine, Bariatric Medicine | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2010-06-16 | 
| Last Update Date | 2022-10-18 |