| NPI | 1568764140 |
|---|---|
| Other Name | CANYON GATE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | VERONICA COLON Credentialing Coordinator 954-656-8855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 12464) |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2010-12-02 |