| NPI | 1538239876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERMINIA GUMABAY HERRERA-TAN Owner 480-246-2376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AZ 29828) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2018-08-15 |