| NPI | 1437575545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JELINA M IP Administrator 480-704-4540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: AZ 0995) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: AZ 0995) |
| 207Q00000X Family Medicine (Licence: AZ 0995) | |
| 208D00000X General Practice | |
| 175F00000X Naturopath (Licence: AZ 03-745) | |
| 208000000X Pediatrics | |
| 208100000X Physical Medicine & Rehabilitation | |
| 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine | |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2014-08-21 |