| NPI | 1417849894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG WONG Director 480-631-4479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2025-07-18 |
| Last Update Date | 2025-07-18 |