NPI 1528752300

Icu423r

Organisation Integrative Medicine Physician Mesa, AZ

Practice location

Address: 1101 W Guadalupe Rd STE 1, Mesa, AZ 85210-7601
Phone: (480) 788-5621
Fax: (480) 779-1277
Mailing address: 202 E Earll Dr STE 360, Phoenix, AZ 85012-2677

Authorised official

Name: Kiup a Kim
Title: Owner
Phone: (602) 730-6438

Registered specialties (2)

Integrative Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 202D00000X

Other Integrative Medicine providers in Arizona →

Community/Behavioral Health Agency

Agencies Taxonomy 251S00000X

Other Community/Behavioral Health providers in Arizona →

Registry record

NPI: 1528752300
Entity type: Organization
NPI issued: 6 Jun 2023
Record last updated: 6 Jun 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.