| Cholla Medical Group, Inc | |
|
10631 S 51st St Ste 8 Phoenix AZ 85044-5225 | |
| (480) 298-9951 | |
| (866) 246-5494 |
| Full Name | Cholla Medical Group, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 10631 S 51st St Ste 8, Phoenix, Arizona |
| Authorized Official Name and Position | Ralph Flores (CEO) |
| Authorized Official Contact | 4802989951 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cholla Medical Group, Inc 10631 S 51st St Ste 8 Phoenix AZ 85044-5225 Ph: (480) 298-9951 | Cholla Medical Group, Inc 10631 S 51st St Ste 8 Phoenix AZ 85044-5225 Ph: (480) 298-9951 |
| NPI Number | 1154443422 |
|---|---|
| Provider Enumeration Date | 04/06/2007 |
| Last Update Date | 04/27/2023 |
| Medicare PECOS PAC ID | 2567569056 |
|---|---|
| Medicare Enrollment ID | O20070517000335 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154443422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 19237 (Arizona) | Primary |
| Provider Name | Roselavender A Richards |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417934902 PECOS PAC ID: 7214825413 Enrollment ID: I20040309000763 |
| Provider Name | Murali D Talluri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275507378 PECOS PAC ID: 5597756460 Enrollment ID: I20041115000885 |
| Provider Name | Judy Y Wu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801122957 PECOS PAC ID: 4183806656 Enrollment ID: I20130826000012 |
| Provider Name | Francisca Adaobi Onyemize |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588249973 PECOS PAC ID: 0840692935 Enrollment ID: I20210712004040 |
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