| NPI | 1346084548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZAK CORONADO Office Administrator 623-521-9113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 207R00000X Internal Medicine | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| 213E00000X Podiatrist | |
| 213EP1101X Podiatrist, Primary Podiatric Medicine | |
| 363L00000X Nurse Practitioner | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2024-06-21 |
| Last Update Date | 2024-06-21 |