| NPI | 1619974219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC BOON Authorized Official 480-567-0269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA Exempt from Licensur) |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2024-10-23 |