Organization
MOON VALLEY MEDICAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE DIANE EDISON DO (PRESIDENT)
(602) 866-2277
Entity
Organization
Contact information
Practice address
13206 NORTH 7TH STREET, PHOENIX, AZ 85022
(602) 866-2277
(602) 866-7998
Mailing address
13206 NORTH 7TH STREET, PHOENIX, AZ 85022
(602) 866-2277
(602) 866-7998
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2491
AZ
Other
Enumeration date
05/25/2007
Last updated
11/23/2009
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