| NPI | 1619615846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROMAN CARRASCO CEO 480-820-5525 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 207Q00000X Family Medicine | |
| 363AM0700X Physician Assistant, Medical | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2023-07-17 |