Chp Care, Pc | |
25812 N 67th Dr Peoria AZ 85383-7135 | |
(602) 332-3363 | |
Not Available |
Full Name | Chp Care, Pc |
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Speciality | Clinic/Center |
Location | 25812 N 67th Dr, Peoria, Arizona |
Authorized Official Name and Position | Marc Leib (CEO) |
Authorized Official Contact | 6027088455 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Chp Care, Pc 25812 N 67th Dr Peoria AZ 85383-7135 Ph: (602) 332-3363 | Chp Care, Pc 25812 N 67th Dr Peoria AZ 85383-7135 Ph: (602) 332-3363 |
NPI Number | 1821444894 |
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Provider Enumeration Date | 05/10/2016 |
Last Update Date | 07/18/2022 |
Medicare PECOS PAC ID | 4688968027 |
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Medicare Enrollment ID | O20160809000508 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821444894 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
363LA2200X | Nurse Practitioner - Adult Health | (* (Not Available)) | Secondary |
Provider Name | Maria J Bustamante |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578735635 PECOS PAC ID: 7214006394 Enrollment ID: I20080515000099 |
Provider Name | Ayin Daleth Hernandez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619433489 PECOS PAC ID: 3476886888 Enrollment ID: I20190617002309 |
Provider Name | Cecilia Espinoza Hallare |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588137855 PECOS PAC ID: 6002146628 Enrollment ID: I20190925001058 |
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