Organization
MATILDA FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALENTINE OKON P.A. (CEO)
(623) 435-3513
Entity
Organization
Contact information
Practice address
5832 W SAN MIGUEL AVE STE 6, GLENDALE, AZ 85301-5907
(623) 435-3513
Mailing address
PO BOX 232, LITCHFIELD PARK, AZ 85340-0232
(623) 435-3513
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
PA2363
AZ
Other
Enumeration date
02/28/2007
Last updated
07/11/2008
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