Organization
PHOENIX DIABETES AND ENDOCRINOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROLE D BAKER (OFFICE ADMINISTRATOR)
(602) 788-3636
Entity
Organization
Contact information
Practice address
4045 E UNION HILLS DR, A107, PHOENIX, AZ 85050-3386
(602) 788-3636
(602) 788-3646
Mailing address
4045 E UNION HILLS DR, A-107, PHOENIX, AZ 85050-3386
(602) 788-3636
(602) 788-3646
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
25915
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
509712
—
AZ
Enumeration date
03/24/2010
Last updated
09/01/2010
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