Organization
DR C'S WEIGHT LOSS AND ANTI-AGING MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENRIQUE M CIFUENTES MD (MEDICAL DIRECTOR)
(480) 245-6677
Entity
Organization
Contact information
Practice address
2737 W BASELINE RD, SUITE 23, TEMPE, AZ 85283-1051
(480) 245-6677
Mailing address
2737 W BASELINE RD, SUITE 23, TEMPE, AZ 85283-1051
(480) 245-6677
(480) 404-6547
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
42048
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
462271
—
AZ
Enumeration date
03/07/2017
Last updated
10/30/2017
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