Provider Demographics
NPI:1346593894
Name:PATRICE, ANALIAH MAHINALANI (ND)
Entity Type:Individual
Prefix:
First Name:ANALIAH
Middle Name:MAHINALANI
Last Name:PATRICE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1934 E CAMELBACK RD STE 120-418
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4126
Mailing Address - Country:US
Mailing Address - Phone:808-313-2386
Mailing Address - Fax:888-862-2418
Practice Address - Street 1:1860 E SALK DR STE B1
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-5590
Practice Address - Country:US
Practice Address - Phone:602-845-0396
Practice Address - Fax:888-862-2418
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-22
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ12-1339207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine