Organization
NENDOS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAZEN KHAYATA (MD)
(480) 315-9620
Entity
Organization
Contact information
Practice address
8550 N CANTA BELLO DR, PARDISE VALLEY, AZ 85253
(480) 315-9620
(480) 323-2515
Mailing address
8550 N CANTA BELLO, PARADISE VALLEY, AZ 85253-8112
(480) 315-9620
(480) 323-2515
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20382
AZ
Other
Enumeration date
06/04/2007
Last updated
08/22/2020
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