Individual
AVIGAYIL MALIA TANAMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2946 E BANNER GATEWAY DRIVE, GILBERT, AZ 85234-2165
(480) 256-6444
(480) 256-3682
Mailing address
2946 E BANNER GATEWAY DRIVE, GILBERT, AZ 85234-2165
(480) 256-6444
(480) 256-3682
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
028735
NY
363A00000X
Physician Assistant
Primary
9202
AZ
363AS0400X
Surgical Physician Assistant
9202
AZ
Other
Enumeration date
08/29/2022
Last updated
09/03/2025
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