# PHOENIX DIABETES AND ENDOCRINOLOGY, LLC

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

## Provider details

- **NPI number:** 1265756977
- **Authorized official:** MRS. CAROLE D BAKER (OFFICE ADMINISTRATOR)
- **Authorized official phone:** (602) 788-3636

## Contact information

- **Practice address:** 4045 E UNION HILLS DR, A107, PHOENIX, AZ 85050-3386
- **Practice address phone:** (602) 788-3636
- **Practice address fax:** (602) 788-3646
- **Mailing address:** 4045 E UNION HILLS DR, A-107, PHOENIX, AZ 85050-3386
- **Mailing address phone:** (602) 788-3636
- **Mailing address fax:** (602) 788-3646

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 25915 | AZ | Yes |

## Other

- **Enumeration date:** 03/24/2010
- **Last updated:** 09/01/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 509712 | — | AZ |