Organization
PHOENIX MED IPA LLC
Active
Other names
PHOENIX MED IPA
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAN NHU BICH PHAN MPH (ADMINISTRATOR)
(818) 399-8996
Entity
Organization
Contact information
Practice address
6739 W CACTUS RD, PEORIA, AZ 85381-5311
(818) 399-8996
Mailing address
6739 W CACTUS RD, PEORIA, AZ 85381-5311
(818) 399-8996
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
01/30/2023
Last updated
01/30/2023
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