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Organization

GOLD CANYON INTERNAL MEDICINE, PLLC

Active
Parent organization
GOLD CANYON INTERNAL MEDICINE, PLLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
GOLD CANYON INTERNAL MEDICINE, PLLC
Authorized official
MR. GEORGE K FAHNBULLEH NA (CEO)
(602) 300-7301
Entity
Organization

Contact information

Practice address
5440 E SOUTHERN AVE STE 105, MESA, AZ 85206-2779
(480) 626-4999
(480) 303-4323
Mailing address
5440 E SOUTHERN AVE STE 10, MESA, AZ 85206-2779
(480) 626-4999
(480) 306-3239

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
10/13/2025
Last updated
10/13/2025
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