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Individual

ASELA R SAN FELIPE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5422 W THUNDERBIRD RD, SUITE #5, GLENDALE, AZ 85306-4700
(602) 843-1480
(602) 843-0168
Mailing address
5422 W THUNDERBIRD RD, SUITE #5, GLENDALE, AZ 85306-4700
(602) 843-1480
(602) 843-0168

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
15061
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
249195
AHCCCS
AZ
Enumeration date
08/02/2006
Last updated
07/08/2007
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