| Arrowhead Medical And Aesthetic Center Llc | |
|
20325 N 51st Ave Suite 100 Glendale AZ 85308-5674 | |
| (623) 434-0336 | |
| (623) 825-2545 |
| Full Name | Arrowhead Medical And Aesthetic Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 20325 N 51st Ave, Glendale, Arizona |
| Authorized Official Name and Position | Terry Espiritu (MEMBER) |
| Authorized Official Contact | 6234340336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arrowhead Medical And Aesthetic Center Llc 20325 N 51st Ave Suite 100 Glendale AZ 85308-5674 Ph: (623) 434-0336 | Arrowhead Medical And Aesthetic Center Llc 20325 N 51st Ave Suite 100 Glendale AZ 85308-5674 Ph: (623) 434-0336 |
| NPI Number | 1780881375 |
|---|---|
| Provider Enumeration Date | 06/28/2007 |
| Last Update Date | 09/30/2008 |
| Medicare PECOS PAC ID | 3072689447 |
|---|---|
| Medicare Enrollment ID | O20080909000252 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780881375 | NPI | - | NPPES |
| 823030 | Medicaid | AZ | |
| Z124160 | Other | AZ | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 31859AZ (Arizona) | Primary |
| Provider Name | Redentor T Espiritu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053303065 PECOS PAC ID: 4587550397 Enrollment ID: I20040226000934 |
| Provider Name | Amory Godwin Grijaldo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487045795 PECOS PAC ID: 0345566402 Enrollment ID: I20150307000237 |
| Provider Name | Maria T Espiritu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336702414 PECOS PAC ID: 5496821860 Enrollment ID: I20201113000495 |
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