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General NPI Number Information
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NPI Number | 1104021088
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Entity Type | Organization
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Legal Business Name | IPC
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10835 N 25TH AVE STE 115
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City | PHOENIX
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State | AZ
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Zip | 85029-3452
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Country | US
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Telephone | 480-517-4929
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Fax |
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Provider Business Mailing Address
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Address Line | 10835 N 25TH AVE STE 115
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City | PHOENIX
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State | AZ
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Zip | 85029-3452
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | STAFF PHYSICIAN
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Name | MARIA RAQUEL SALDIVAR
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Credential | MD
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Telephone | 480-517-4929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number |
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License Number State |
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