| NPI | 1396477725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE CARRAZCO Owner 480-820-5525 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 207Q00000X Family Medicine | |
| 363AM0700X Physician Assistant, Medical | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2022-06-24 |
| Last Update Date | 2025-08-17 |