Organization · NPI-2

Arizona Essential Holistic Care

Family Medicine · Glendale, AZ

NPI number1497246482
StatusActive
Last updated in NPPESNov 25, 2019

Details

NPI
1497246482
Entity type
Organization (NPI-2)
Legal business name
Arizona Essential Holistic Care
Organization subpart
No
Enumeration date
May 24, 2018
Last updated
Nov 25, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineAP5625AZYes

Other names

  • Arizona Essential Holistic Care (Doing Business As)
  • Arizona Essential Holistic Care, LLC (Former Legal Business Name)

Practice location

5700 W Olive Ave Ste 102
Glendale, AZ 85302

Phone 623-738-6062 · Fax 602-354-9462

Mailing address

5700 W Olive Ave Ste 102
Glendale, AZ 85302-3147

Phone 602-738-6062 · Fax 602-354-9462

Other practice locations

7200 W Bell Rd Bldg B
Glendale, AZ 85308-8529

Phone 602-738-6062

Authorized official

Alodia Banuelos Domingo
Provider/Owner
6237386062

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