Organization
BONITA WOMEN'S CARE, P.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GRACIELA LOPEZ (OFFICE MANAGER)
(602) 240-2401
Entity
Organization
Contact information
Practice address
380 E VIRGINIA AVE, PHOENIX, AZ 85004-1208
(602) 274-7117
(602) 274-7116
Mailing address
650 W MARYLAND AVE STE 1, PHOENIX, AZ 85013-1399
(602) 240-2401
(602) 792-0244
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
21210
AZ
Other
Enumeration date
04/24/2012
Last updated
04/24/2012
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