Individual
ELOSAMA A DIAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4030 W GRANDVIEW RD, PHOENIX, AZ 85053-2731
(480) 599-5917
Mailing address
6127 W WAGONER RD, GLENDALE, AZ 85308-1150
(214) 774-7006
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
06/23/2023
Last updated
06/23/2023
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