| NPI | 1316565930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA LOUELLA NABONG Physician 602-374-3396 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2020-07-09 |