| NPI | 1699649301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REYNALDO DELA CRUZ Owner 623-289-3709 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2025-10-03 |
| Last Update Date | 2025-10-03 |