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General NPI Number Information
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NPI Number | 1457987679
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Entity Type | Organization
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Legal Business Name | AZMED4U
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Dates
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Enumeration Date | 03/19/2020
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 270 E HUNT HWY STE 16-189
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85143-6009
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Country | US
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Telephone | 480-349-7169
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Fax | 480-546-3765
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Provider Business Mailing Address
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Address Line | 270 E HUNT HWY STE 16-189
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85143-6009
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Country | US
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Telephone | 480-369-3171
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Fax | 480-546-3765
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Authorized Official
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Title or Position | OWNER
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Name | LEANN VANDUYN
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Credential | NP
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Telephone | 480-369-3171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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