# CAMELBACK MOUNTAIN MEDICAL ASSOCIATES PC

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

## Provider details

- **NPI number:** 1164776845
- **Authorized official:** DR. EDWARD GRIFFIN CIPOLLA DO (OWNER/PRESIDENT)
- **Authorized official phone:** (602) 266-4383

## Contact information

- **Practice address:** 120 E MONTEREY WAY, PHOENIX, AZ 85012-2618
- **Practice address phone:** (602) 266-4383
- **Practice address fax:** (602) 266-4384
- **Mailing address:** 120 E MONTEREY WAY, PHOENIX, AZ 85012-2618
- **Mailing address phone:** (602) 266-4383
- **Mailing address fax:** (602) 266-4384

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2811 | AZ | Yes |

## Other

- **Enumeration date:** 11/02/2012
- **Last updated:** 11/02/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 341769 | — | AZ |