Individual
DR. AMANDA MODESTA KEYHANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
202 E EARLL DRIVE, #150, PHOENIX, AZ 85012
(602) 248-8258
(602) 248-8259
Mailing address
202 E EARLL DR, #150, PHOENIX, AZ 85012-2634
(602) 248-8258
(602) 248-8259
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24512
AZ
Other
Enumeration date
05/25/2006
Last updated
12/04/2012
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