Organization
FALA MEDICAL CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRESCHTA MIRZAKHEL (PRACTICE ADMINISITRATOR)
(480) 258-8264
Entity
Organization
Contact information
Practice address
14749 W MOUNTAIN VIEW BLVD STE 138, SURPRISE, AZ 85374-2704
(623) 738-0440
(480) 374-8051
Mailing address
14749 W MOUNTAIN VIEW BLVD STE 138, SURPRISE, AZ 85374-2704
(623) 738-0440
(480) 374-8051
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
546663
—
AZ
Enumeration date
01/28/2020
Last updated
05/08/2023
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