Organization
AZ SKIN SUB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARVIS TZENG DO (PRESIDENT)
(480) 389-6863
Entity
Organization
Contact information
Practice address
10810 N TATUM BLVD STE 102-132, PHOENIX, AZ 85028-6055
(480) 389-6863
(888) 819-9648
Mailing address
10810 N TATUM BLVD STE 102-132, PHOENIX, AZ 85028-6055
(480) 389-6863
(888) 819-9648
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811137722
—
AZ
Enumeration date
12/13/2022
Last updated
12/13/2022
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