Individual
HONG K ONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9165 W THUNDERBIRD RD, STE 200, PEORIA, AZ 85381-4847
(623) 876-3870
(623) 815-0087
Mailing address
13640 N PLAZA DEL RIO BLVD, PEORIA, AZ 85381-4846
(623) 876-3800
(623) 815-0087
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
10283
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236811
—
AZ
Enumeration date
06/07/2006
Last updated
01/24/2008
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