| NPI | 1609921378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AURELIANO E CIFUENTES Md/Owner 602-323-0904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: AZ 11483) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2024-08-12 |