Organization
MOUNTAINSIDE MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIBAN OSMAN FNP (FAMILY NURSE PRACTITIONER)
(480) 687-7190
Entity
Organization
Contact information
Practice address
4139 W BELL RD STE 8&9, PHOENIX, AZ 85053-2753
(507) 319-7780
Mailing address
PO BOX 9365, SURPRISE, AZ 85374-0139
(480) 687-7190
(480) 687-7292
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/18/2019
Last updated
05/07/2020
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