Organization
ARIZONA STATE INTERNAL MEDICINE ASSOCIATES PLLC
Active
Organization
ARIZONA STATE INTERNAL MEDICINE ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LETICIA GANGAN JACINTO MD (PRESIDENT)
(602) 361-8099
Entity
Organization
Contact information
Practice address
17100 N 67TH AVE, SUITE 401, GLENDALE, AZ 85308-3605
(602) 795-8698
(602) 795-8699
Mailing address
17100 N 67TH AVE, SUITE 401, GLENDALE, AZ 85308-3605
(602) 795-8698
(602) 795-8699
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29006
AZ
Other
Enumeration date
10/25/2012
Last updated
10/25/2012
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