| NPI | 1417573742 |
|---|---|
| Former Legal Business Name | NA |
| Entity Type | Organization |
| Authorized Contact | BILAL F. SHANTI Medical Director/Owner 480-473-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2023-04-20 |