| NPI | 1780047985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIJAYABHANU MAHADEVAN Physician/Owner 623-219-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: AZ 37475) |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2026-02-12 |