| NPI | 1760833958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUNGWOO LEE Owner 480-233-2003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AZ D008679) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2016-06-29 |