Gold Canyon Internal Medicine, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GOLD CANYON INTERNAL MEDICINE, PLLC

Practice address

5440 E Southern Ave Ste 105
Mesa, AZ 85206-2779

Phone

(480) 626-4999

Fax

(480) 303-4323

NPI assigned

Oct 13, 2025

Organization subpart

Yes

Parent organization

GOLD CANYON INTERNAL MEDICINE, PLLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. George K Fahnbulleh, NA

Title

Ceo

Phone

(602) 300-7301

Specialties & licenses 1

Addresses

Tax ID family

Gold Canyon Internal Medicine PLLC2 organizations share this tax ID, including this one

Part of

Gold Canyon Internal Medicine PLLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Gold Canyon Internal Medicine

  • Internal Medicine Physician
  • Gold Canyon, AZ
  • NPI 1417112541
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Gold Canyon Internal Medicine

  • Internal Medicine Physician
  • Gold Canyon, AZ
  • NPI 1417112541
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerrelle M Copeland, M.D.

  • Internal Medicine Physician
  • Gold Canyon, AZ
  • NPI 1790784643
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1760313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1669348157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 E SOUTHERN AVE STE 10",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062779",
            "telephone_number": "480-626-4999",
            "fax_number": "480-306-3239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 E SOUTHERN AVE STE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062779",
            "telephone_number": "480-626-4999",
            "fax_number": "480-303-4323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD CANYON INTERNAL MEDICINE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOLD CANYON INTERNAL MEDICINE, PLLC",
        "enumeration_date": "2025-10-13",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "FAHNBULLEH",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-300-7301",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell Godwin, DPT
• Stephanie Gofron, LMSW
• Colin P Goggins, MD
• Audrey Goh
• Janessa Gojkovich, SLPA
• Lisa Loree Gold, PH.D.
• Kimberly Goldberg, PHARMD
• Mark Daniel Goldberg, MD
• Amanda Lael Golde, LMT
• Golden Health at Home Personal Care Services LLC

• Internal Medicine Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.