| NPI | 1508406075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS J LOPEZ Owner/Manager 602-254-0390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2024-08-12 |