Individual
CYNTHIA L KOOIMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2940 E BANNER GATEWAY DR, STE 200, GILBERT, AZ 85234-2168
(602) 648-5444
(602) 772-3801
Mailing address
PO BOX 80217, PHOENIX, AZ 85060-0217
(602) 385-2115
(480) 418-3323
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
31186
AZ
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
31186
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115551
—
AZ
01
—
3Z3971
HEALTHNET
AZ
Enumeration date
05/20/2006
Last updated
09/01/2022
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