Organization · NPI-2

Obl

Integrative Medicine · Phoenix, AZ

NPI number1508430661
StatusActive
Last updated in NPPESMay 4, 2023

Details

NPI
1508430661
Entity type
Organization (NPI-2)
Legal business name
Obl
Organization subpart
No
Enumeration date
May 13, 2021
Certification date
May 4, 2023
Last updated
May 4, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
202D00000X Integrative Medicine––Yes
207Q00000X Family Medicine––
208600000X Surgery––
251S00000X Community/Behavioral Health––

Practice location

14804 N Cave Creek Rd Ste 200
Phoenix, AZ 85032-4945

Phone 480-240-5613 · Fax 480-205-1063

Mailing address

202 E Earll Dr Ste 360
Phoenix, AZ 85012-2677

Phone 480-788-5621 · Fax 480-779-1277

Other practice locations

202 E Earll Dr Ste 360
Phoenix, AZ 85012-2677

Phone 480-788-5621 · Fax 480-779-1277

13640 N 99th Ave Ste 200
Sun City, AZ 85351-0001

Phone 480-788-5621 · Fax 480-779-1277

Authorized official

Kiup Kim
Founder / Ceo
4807885621

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