Organization
ADVANCED MINIMALLY INVASIVE SURGICAL
Active
Other names
Trinity Medical Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
KIUP ALEXANDER KIM (OWNER)
(480) 323-6072
Entity
Organization
Contact information
Practice address
14804 N CAVE CREEK RD STE 200, PHOENIX, AZ 85032-4945
(480) 240-5613
Mailing address
202 E EARLL DR STE 360, PHOENIX, AZ 85012-2677
(480) 240-5613
Taxonomy
Speciality
Code
Description
License number
State
202D00000X
Integrative Medicine Physician
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148484
—
AZ
01
—
OTC12137
AZDHS
AZ
Enumeration date
01/04/2023
Last updated
09/26/2023
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