| Mlm Family Llc | |
|
15410 S Mountain Pkwy Suite 105 Phoenix AZ 85044-6691 | |
| (602) 339-3669 | |
| Not Available |
| Full Name | Mlm Family Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 15410 S Mountain Pkwy, Phoenix, Arizona |
| Authorized Official Name and Position | Lana Khatib (PROVIDER) |
| Authorized Official Contact | 6023393669 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mlm Family Llc 2031 E Glenhaven Dr Phoenix AZ 85048-8122 Ph: (602) 339-3669 | Mlm Family Llc 15410 S Mountain Pkwy Suite 105 Phoenix AZ 85044-6691 Ph: (602) 339-3669 |
| NPI Number | 1245648088 |
|---|---|
| Provider Enumeration Date | 07/24/2014 |
| Last Update Date | 07/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245648088 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 42064 (Arizona) | Primary |
| 363AM0700X | Physician Assistant - Medical | 5212 (Arizona) | Secondary |
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