Individual
MIA DIMAYUGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5048 W NORTHERN AVE STE 106, GLENDALE, AZ 85301-1558
(623) 435-0190
Mailing address
2811 W DEER VALLEY RD APT 2065, PHOENIX, AZ 85027-2383
(224) 567-0983
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/14/2026
Last updated
07/14/2026
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