Individual
KUOC MATHIANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20425 N 7TH ST APT 3072, PHOENIX, AZ 85024-6019
(480) 612-7532
Mailing address
20425 N 7TH ST APT 3072, PHOENIX, AZ 85024-6019
(480) 612-7532
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
218491
AZ
367500000X
Certified Registered Nurse Anesthetist
Primary
218491
AZ
Other
Enumeration date
09/06/2022
Last updated
07/07/2025
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