Organization
ALLIANCE WITH THE COVENANT OF THE TRINITY ARIZONA INC
Active
Other names
ACT Medical Group Arizona
Organization subpart
No
Provider details
NPI number
Authorized official
ZANDRA GONZALES (CFO/COO)
(213) 709-0777
Entity
Organization
Contact information
Practice address
2 N CENTRAL AVE FL 18, PHOENIX, AZ 85004-2322
(213) 709-0777
Mailing address
11245 DELANO ST, NORTH HOLLYWOOD, CA 91606-4219
(213) 709-0777
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/12/2019
Last updated
11/12/2019
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