Individual
BOB M CHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4110 W MAGDALENA LN, LAVEEN, AZ 85339-2510
(480) 343-2251
Mailing address
4110 W MAGDALENA LN, LAVEEN, AZ 85339-2510
(480) 343-2251
Taxonomy
Speciality
Code
Description
License number
State
342000000X
Transportation Network Company
Primary
23283790
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202110211454819
23283790
AZ
Enumeration date
11/03/2021
Last updated
11/03/2021
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