| NPI | 1528002219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOWARD P TAY Managing Member 623-979-1717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AZ OSC4105) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2007-08-20 |