| Coronado Internal Medicine Pc | |
|
6365 E Tanque Verde Rd Suite 210 Tucson AZ 85715-3830 | |
| (520) 885-2072 | |
| (520) 721-9464 |
| Full Name | Coronado Internal Medicine Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6365 E Tanque Verde Rd, Tucson, Arizona |
| Authorized Official Name and Position | Jeffrey S Mayer (PRESIDENT) |
| Authorized Official Contact | 5208852072 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coronado Internal Medicine Pc Po Box 43100 Tucson AZ 85733-3100 Ph: (520) 722-3777 | Coronado Internal Medicine Pc 6365 E Tanque Verde Rd Suite 210 Tucson AZ 85715-3830 Ph: (520) 885-2072 |
| NPI Number | 1932293032 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 05/01/2013 |
| Medicare PECOS PAC ID | 3274533237 |
|---|---|
| Medicare Enrollment ID | O20061222000241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932293032 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 23701 (Arizona) | Primary |
| Provider Name | Jeffrey S Mayer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538253620 PECOS PAC ID: 7810984374 Enrollment ID: I20040427001027 |
| Provider Name | Betty Blangsted |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932613957 PECOS PAC ID: 7618206988 Enrollment ID: I20190911002847 |
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