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Organization
SOB523T
Active
Organization
SOB523T
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THUY NGUYEN (DIRECTOR)
(602) 492-8606
Entity
Organization
Contact information
Practice address
202 E EARLL DR STE 360, PHOENIX, AZ 85012-2677
(480) 788-5621
(480) 779-1277
Mailing address
202 E EARLL DR STE 360, PHOENIX, AZ 85012-2677
(480) 788-5621
(480) 779-1277
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/15/2025
Last updated
09/22/2025
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