| Organization Name: | GOODYEAR FAMILY MEDICINE PC |
| NPI Number: | 1104015015 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KAMEL SADEK (OWNER) |
| Mailing Address: | 10320 W Mcdowell Rd Bldg. I, Ste.9029 Avondale |
| State: | AZ US |
| Postal Code: | 853924863 |
| Phone Number: | 6239255660 |
| Fax Number: | 6239323898 |
| NPI Enumeration Date: | 10/16/2007 |
| NPI Last Update Date: | 02/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 28344 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |