| |
7717 W Deer Valley Rd Peoria AZ 85382-2102 | |
(623) 561-6300 | |
(623) 572-5400 |
Full Name | |
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Speciality | Family Medicine |
Location | 7717 W Deer Valley Rd, Peoria, Arizona |
Authorized Official Name and Position | Robert Philip Luberto (OWNER) |
Authorized Official Contact | 6235616300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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7717 W Deer Valley Rd Peoria AZ 85382-2102 Ph: (623) 561-6300 | 7717 W Deer Valley Rd Peoria AZ 85382-2102 Ph: (623) 561-6300 |
NPI Number | 1144365420 |
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Provider Enumeration Date | 02/21/2007 |
Last Update Date | 12/17/2010 |
Medicare PECOS PAC ID | 8426016015 |
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Medicare Enrollment ID | O20041229000559 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144365420 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
Provider Name | Robert P Luberto |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1760441174 PECOS PAC ID: 3173509163 Enrollment ID: I20040629001036 |
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