Individual
DR. TANYA KALANI VON DETTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2000 W BETHANY HOME RD, FAMILY MEDICINE CENTER, PHOENIX, AZ 85015-2443
(602) 246-5525
Mailing address
500 UNIVERSITY AVE APT 1429, HONOLULU, HI 96826-4938
(218) 326-3636
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD19755
HI
390200000X
Student in an Organized Health Care Education/Training Program
R75293
AZ
Other
Enumeration date
06/23/2015
Last updated
05/30/2024
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