Camelback Mountain Medical Associates Pc | |
120 E Monterey Way Phoenix AZ 85012-2618 | |
(602) 266-4383 | |
(602) 266-4384 |
Full Name | Camelback Mountain Medical Associates Pc |
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Speciality | Family Medicine |
Location | 120 E Monterey Way, Phoenix, Arizona |
Authorized Official Name and Position | Edward Griffin Cipolla (OWNER/PRESIDENT) |
Authorized Official Contact | 6022664383 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Camelback Mountain Medical Associates Pc 120 E Monterey Way Phoenix AZ 85012-2618 Ph: (602) 266-4383 | Camelback Mountain Medical Associates Pc 120 E Monterey Way Phoenix AZ 85012-2618 Ph: (602) 266-4383 |
NPI Number | 1164776845 |
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Provider Enumeration Date | 11/02/2012 |
Last Update Date | 11/02/2012 |
Medicare PECOS PAC ID | 4486809779 |
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Medicare Enrollment ID | O20130313000427 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164776845 | NPI | - | NPPES |
341769 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 2811 (Arizona) | Primary |
Provider Name | Edward G Cipolla |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1144374281 PECOS PAC ID: 0042230476 Enrollment ID: I20051130000806 |
Provider Name | Lucy Pitts |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215368964 PECOS PAC ID: 1052541364 Enrollment ID: I20140306001827 |
Provider Name | Charlene F Baldwin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033546411 PECOS PAC ID: 2961628292 Enrollment ID: I20140730002884 |
Provider Name | Janna Tobin Roberts |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033536362 PECOS PAC ID: 8729397245 Enrollment ID: I20151023002505 |
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