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General NPI Number Information
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NPI Number | 1497074223
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Entity Type | Organization
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Legal Business Name | HOPE DIABETES OF GILBERT LLC
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Dates
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Enumeration Date | 05/18/2010
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Last Update Date | 10/22/2010
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Provider Practice Location Address
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Address Line | 875 N GREENFIELD RD SUITE 104
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City | GILBERT
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State | AZ
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Zip | 85234-5044
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Country | US
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Telephone | 480-422-5030
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Fax | 480-247-3989
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Provider Business Mailing Address
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Address Line | 3317 S HIGLEY RD 114-118
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City | GILBERT
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State | AZ
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Zip | 85297-5436
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Country | US
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Telephone | 480-422-5030
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Fax | 480-247-3989
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Authorized Official
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Title or Position | CEO
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Name | MRS. MARILYN CAPOTE
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Credential |
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Telephone | 480-422-5030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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