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13060 South Sunland Gin Road Arizona City AZ 85123 | |
(520) 350-7011 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 13060 South Sunland Gin Road, Arizona City, Arizona |
Authorized Official Name and Position | Samuel Efrain Sanchez (CEO) |
Authorized Official Contact | 5627458863 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 1775 Arizona City AZ 85123-1290 Ph: () - | 13060 South Sunland Gin Road Arizona City AZ 85123 Ph: (520) 350-7011 |
NPI Number | 1972940237 |
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Provider Enumeration Date | 05/28/2013 |
Last Update Date | 05/28/2013 |
Medicare PECOS PAC ID | 0446491005 |
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Medicare Enrollment ID | O20130724000035 |
Identifier | Type | State | Issuer |
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1972940237 | NPI | - | NPPES |
1780693861 | Other | CA | NPI |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 005911 (Arizona) | Primary |
207QA0505X | Family Medicine - Adult Medicine | 005911 (Arizona) | Secondary |
Provider Name | Samuel Sanchez |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1780693861 PECOS PAC ID: 2264338714 Enrollment ID: I20130724000094 |