# BETHANY MEDICAL L.L.C

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053433912
- **Authorized official:** VALENTINE E OKON (ADMINISTRATOR)
- **Authorized official phone:** (623) 847-9800

## Contact information

- **Practice address:** 5832 W. SAN MIGUEL AVE \#6, GLENDAL, AZ 85301
- **Practice address phone:** (623) 939-6224
- **Practice address fax:** (623) 939-6224
- **Mailing address:** 5832 W. SAN MIGUEL AVE \#6, GLENDAL, AZ 85301
- **Mailing address phone:** (623) 939-6224
- **Mailing address fax:** (623) 939-6224

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 15873 | AZ | Yes |

## Other

- **Enumeration date:** 04/04/2007
- **Last updated:** 07/31/2008