| Arizona Family & Geriatric Medicine Pllc | |
|
5602 E. Main St. Mesa AZ 85205 | |
| (480) 854-9004 | |
| (480) 832-1858 |
| Full Name | Arizona Family & Geriatric Medicine Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5602 E. Main St., Mesa, Arizona |
| Authorized Official Name and Position | Minh Luong (PHYSICIAN, CO-OWNER) |
| Authorized Official Contact | 4808549004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arizona Family & Geriatric Medicine Pllc 5602 E. Main St. Mesa AZ 85205 Ph: (480) 854-9004 | Arizona Family & Geriatric Medicine Pllc 5602 E. Main St. Mesa AZ 85205 Ph: (480) 854-9004 |
| NPI Number | 1740596733 |
|---|---|
| Provider Enumeration Date | 08/27/2010 |
| Last Update Date | 10/12/2017 |
| Medicare PECOS PAC ID | 3476733551 |
|---|---|
| Medicare Enrollment ID | O20110207000497 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740596733 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 41809 (Arizona) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (Arizona) | Primary |
| Provider Name | Minh T Luong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083820781 PECOS PAC ID: 0446343164 Enrollment ID: I20090724000175 |
| Provider Name | Priscilla M Luong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770810715 PECOS PAC ID: 6800926932 Enrollment ID: I20100615000950 |
| Provider Name | Phuong Thi Ngoc Pham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760094098 PECOS PAC ID: 3971940388 Enrollment ID: I20240321000639 |
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