| NPI | 1659041374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA VERA Member Manager 480-268-0477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246Z00000X Specialist/Technologist, Other |
| Additional Taxonomies | 174400000X Specialist |
| 225500000X Specialist/Technologist | |
| 235500000X Specialist/Technologist | |
| 261QH0100X Clinic/Center Health Service | |
| 302F00000X Exclusive Provider Organization | |
| 302R00000X Health Maintenance Organization | |
| 305R00000X Preferred Provider Organization | |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2021-09-27 |