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Organization

FRESH START IC, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANGELICA ZEPEDA (ADMINISTRATIVE ASSISTANT)
(480) 749-0282
Entity
Organization

Contact information

Practice address
9118 N CAVE CREEK RD, PHOENIX, AZ 85020-2525
(480) 900-7622
Mailing address
PO BOX 26063, PHOENIX, AZ 85068-6063

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
03/22/2023
Last updated
03/22/2023
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