| Diabetes America Az Llc | |
|
2875 W Ray Rd Suite 16 Chandler AZ 85224-3524 | |
| (480) 855-6075 | |
| (480) 855-6085 |
| Full Name | Diabetes America Az Llc |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 2875 W Ray Rd, Chandler, Arizona |
| Authorized Official Name and Position | Tina Johnson (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 7138405245 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diabetes America Az Llc 13171 Misty Willow Dr Houston TX 77070-5635 Ph: (832) 237-3500 | Diabetes America Az Llc 2875 W Ray Rd Suite 16 Chandler AZ 85224-3524 Ph: (480) 855-6075 |
| NPI Number | 1992966998 |
|---|---|
| Provider Enumeration Date | 06/23/2008 |
| Last Update Date | 08/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992966998 | NPI | - | NPPES |
| 407282 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
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