Organization Name: | MATILDA FAMILY MEDICINE |
NPI Number: | 1083742449 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VALENTINE OKON (CEO) |
Mailing Address: | 5832 W San Miguel Ave Ste 6 Glendale |
State: | AZ US |
Postal Code: | 853015907 |
Phone Number: | 6234353513 |
Fax Number: | |
NPI Enumeration Date: | 02/28/2007 |
NPI Last Update Date: | 07/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 302R00000X |
License Number: | PA2363 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Managed Care Organizations |
Taxonomy Classification: | Health Maintenance Organization |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |