| East Valley Family Practice, Llc | |
|
3885 S Val Vista Dr #103 Gilbert AZ 85297-7313 | |
| (480) 269-8436 | |
| (480) 269-8438 |
| Full Name | East Valley Family Practice, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3885 S Val Vista Dr, Gilbert, Arizona |
| Authorized Official Name and Position | Sunita Gupta (PROPRIETOR/DIRECTOR) |
| Authorized Official Contact | 4802698436 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Valley Family Practice, Llc 3885 S Val Vista Dr #103 Gilbert AZ 85297-7313 Ph: (480) 269-8436 | East Valley Family Practice, Llc 3885 S Val Vista Dr #103 Gilbert AZ 85297-7313 Ph: (480) 269-8436 |
| NPI Number | 1548509490 |
|---|---|
| Provider Enumeration Date | 02/12/2013 |
| Last Update Date | 04/04/2013 |
| Medicare PECOS PAC ID | 3870730559 |
|---|---|
| Medicare Enrollment ID | O20130516000693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548509490 | NPI | - | NPPES |
| 453323 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 41594 (Arizona) | Primary |
| Provider Name | Sunita Gupta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750319265 PECOS PAC ID: 7113000795 Enrollment ID: I20090901000277 |
| Provider Name | Angela Marie Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639553704 PECOS PAC ID: 3476860859 Enrollment ID: I20150917000372 |
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