# PHOENIX VA HEALTH CARE SYSTEM

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

## Provider details

- **NPI number:** 1790022234
- **Authorized official:** MS. JENNIE GUAN (REGISTERED DIETITIAN)
- **Authorized official phone:** (305) 277-5551

## Contact information

- **Practice address:** 650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
- **Practice address phone:** (602) 277-5551
- **Mailing address:** 15231 N 66TH DR, GLENDALE, AZ 85306-3117

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QV0200X | VA Clinic/Center | 1082914 | AZ | Yes |

## Other

- **Enumeration date:** 01/03/2013
- **Last updated:** 01/03/2013