Organization
GRACE ZLAKET MATTA MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GRACE ZLAKET-MATTA (MEDICAL DIRECTOR - PRESIDENT)
(480) 219-5597
Entity
Organization
Contact information
Practice address
9336 E, RAINTREE DR., STE 150, SCOTTSDALE, AZ 85260-7314
(480) 219-5597
(480) 219-5547
Mailing address
9336 E, RAINTREE DR., STE 150, SCOTTSDALE, AZ 85260-7314
(480) 219-5597
(480) 219-5547
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
23480
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
326480
—
AZ
Enumeration date
06/21/2007
Last updated
10/23/2024
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