| NPI | 1376650770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDUARDO SALCIDO ALCANTAR Owner 480-968-9890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 17509) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 3275) |
| 363L00000X Nurse Practitioner (Licence: AZ rn106409) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2020-08-22 |