Organization
GOLD CANYON INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE K FAHNBULLEH (CEO)
(480) 525-6161
Entity
Organization
Contact information
Practice address
6724 S KINGS RANCH RD STE 102, GOLD CANYON, AZ 85118-2963
(480) 626-4999
(480) 304-3239
Mailing address
6724 S KINGS RANCH RD STE 102, GOLD CANYON, AZ 85118-2963
(480) 626-4999
(480) 304-3239
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25933
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404723
—
AZ
Enumeration date
07/29/2008
Last updated
01/19/2026
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