Basic Information
| Provider Information | |||||||||
| NPI: | 1467615971 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DELGADO-THAI | ||||||||
| FirstName: | JAMAEL | ||||||||
| MiddleName: | THERESA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PHOENIX INDIAN MEDICAL CENTER - PRIMARY CARE | ||||||||
| Address2: | 4212 N. 16TH ST | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022631200 | ||||||||
| FaxNumber: | 6022005383 | ||||||||
| Practice Location | |||||||||
| Address1: | PHOENIX INDIAN MEDICAL CENTER | ||||||||
| Address2: | 4212 N. 16TH ST | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022631200 | ||||||||
| FaxNumber: | 6022005383 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2008 | ||||||||
| LastUpdateDate: | 11/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 70781 | AZ | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | AZ44473 | AZ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.