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General NPI Number Information
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NPI Number | 1639348303
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Entity Type | Organization
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Legal Business Name | WESTFAM SA DE CV PC
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 2330 N 75TH AVE SUITE 108
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City | PHOENIX
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State | AZ
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Zip | 85035-1200
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Country | US
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Telephone | 623-873-5820
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Fax |
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Provider Business Mailing Address
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Address Line | 2330 N 75TH AVE SUITE 108
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City | PHOENIX
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State | AZ
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Zip | 85035-1200
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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 | PRESIDENT
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Name | DR. MARK FRIEDMAN
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Credential | MD
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Telephone | 623-873-5820
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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 | 17039
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License Number State | AZ
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