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Organization
CANYON FAMILY MEDICINE PLLC
Active
Organization
CANYON FAMILY MEDICINE PLLC
Active
Other names
Canyon Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA AYN HAFEZ NP (FOUNDER)
(602) 805-4914
Entity
Organization
Contact information
Practice address
6242 E ARBOR AVE STE 118, MESA, AZ 85206-1309
(602) 805-4914
(602) 805-4917
Mailing address
6242 E ARBOR AVE STE 118, MESA, AZ 85206-1309
(602) 805-4914
(602) 805-4917
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104341
—
AZ
Enumeration date
11/02/2021
Last updated
03/10/2025
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