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Specialty details in registry · Maricopa, AZ

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At a glance

41277 W Cielo Ln, Maricopa, AZ 85138-3783

NPPES record updated Jun 17, 2025. Public records can lag behind changes at a practice.

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  • Do you accept my specific insurance plan?
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Insurance participation and appointment availability are not established by these public records.

Practice location

41277 W Cielo Ln
Maricopa, AZ 85138-3783
Professional details: NPI, taxonomy & registry record
NPI1639065402
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
320600000X
Enumeration date
Jun 17, 2025
Record updated
Jun 17, 2025
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

261QD1600X

Specialty details in registry

311Z00000X

Specialty details in registry

320600000X · Primary

Specialty details in registry

320900000X

Specialty details in registry

332U00000X

Specialty details in registry

347C00000X

Specialty details in registry

385HR2060X

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

41277 W Cielo Ln
Maricopa, AZ 85138-3783
Phone
(480) 202-0001
Mailing address
41277 W CIELO LN

MARICOPA, AZ 851383783
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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