Organization
CANYON FAMILY MEDICINE PLLC
Active
Other names
Canyon Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA AYN HAFEZ NP (FOUNDER)
(602) 805-4914
Entity
Organization
Contact information
Practice address
6242 E ARBOR AVE STE 118, MESA, AZ 85206-1309
(602) 805-4914
(602) 805-4917
Mailing address
6242 E ARBOR AVE STE 118, MESA, AZ 85206-1309
(602) 805-4914
(602) 805-4917
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104341
—
AZ
Enumeration date
11/02/2021
Last updated
03/10/2025
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