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NPI Profile for BANNER PHYSICIAN SPECIALISTS ARIZONA LLC in GLENDALE, AZ.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Nutrition, Education |
133NN1002X | |||
Multi-Specialty |
261QM1300X | 70 | Clinic or Group Practice |
| NPI Number | 1164150363 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 08/15/2022 | |
| Last updated | 08/15/2022 - About 4 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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BANNER PHYSICIAN SPECIALISTS ARIZONA LLC