| NPI | 1871678979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN A PINEDO Podiatrist 602-340-8686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: AZ az0154) |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2023-07-10 |