Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 52713 | AZ |
Y | 207QS0010X | Family Doctor - Sports Medicine | 52713 | AZ |
NPI | 1164798351 |
---|---|
Provider Name | Steven Poon |
First Address | Scottsdale, AZ 85259-5499 |
Second Address | Scottsdale, AZ 85259-5499 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2012 |
Last Update Date | 03/05/2021 |