Organization
PHOENIX WEST INTERNAL MEDICINE LLC
Active
Organization
PHOENIX WEST INTERNAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERNANDO RAUL DE CASTRO M.D. (OWNER)
(623) 322-1145
Entity
Organization
Contact information
Practice address
4150 N 108TH AVE, STE 142, PHOENIX, AZ 85037-5467
(623) 322-1145
(623) 466-9552
Mailing address
9524 W CAMELBACK RD, STE 130 PMB186, GLENDALE, AZ 85305-3104
(623) 322-1145
(623) 466-9552
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30062
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
648735
—
AZ
Enumeration date
07/02/2006
Last updated
03/08/2011
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