| Arizona State Internal Medicine Associates Pllc | |
|
17100 N 67th Ave Suite 401 Glendale AZ 85308-3605 | |
| (602) 795-8698 | |
| (602) 795-8699 |
| Full Name | Arizona State Internal Medicine Associates Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 17100 N 67th Ave, Glendale, Arizona |
| Authorized Official Name and Position | Leticia Gangan Jacinto (PRESIDENT) |
| Authorized Official Contact | 6023618099 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Arizona State Internal Medicine Associates Pllc 17100 N 67th Ave Suite 401 Glendale AZ 85308-3605 Ph: (602) 795-8698 | Arizona State Internal Medicine Associates Pllc 17100 N 67th Ave Suite 401 Glendale AZ 85308-3605 Ph: (602) 795-8698 |
| NPI Number | 1255684437 |
|---|---|
| Provider Enumeration Date | 10/25/2012 |
| Last Update Date | 10/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255684437 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 29006 (Arizona) | Primary |
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