Organization · NPI-2

Alvin Mathew, DO, LLC

Internal Medicine · Glendale, AZ

NPI number1083897623
StatusActive
Last updated in NPPESFeb 23, 2012

Details

NPI
1083897623
Entity type
Organization (NPI-2)
Legal business name
Alvin Mathew, DO, LLC
Organization subpart
No
Enumeration date
Dec 5, 2007
Last updated
Feb 23, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine4420AZYes

Practice location

18275 N 59th Ave
St 138
Glendale, AZ 85308-1260

Phone 602-564-0078 · Fax 602-564-1154

Mailing address

18275 N 59th Ave
St 138
Glendale, AZ 85308-1260

Phone 602-564-0078 · Fax 602-564-1154

Authorized official

Alvin Mathew
Pressident
4808125589

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