Provider Demographics
NPI:1235809583
Name:MGPP MEDICAL PLLC
Entity Type:Organization
Organization Name:MGPP MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN /OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:
Authorized Official - Last Name:IJAOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-862-9197
Mailing Address - Street 1:1720 E BOSTON ST STE 104
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-6227
Mailing Address - Country:US
Mailing Address - Phone:480-745-3705
Mailing Address - Fax:480-745-3709
Practice Address - Street 1:1720 E BOSTON ST STE 104
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-6227
Practice Address - Country:US
Practice Address - Phone:480-745-3705
Practice Address - Fax:480-745-3709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty