Fountains Family Care, P.c. | |
3930 S Alma School Rd Ste 1 Chandler AZ 85248-4510 | |
(480) 726-6632 | |
(480) 726-3868 |
Full Name | Fountains Family Care, P.c. |
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Speciality | Family Medicine |
Location | 3930 S Alma School Rd, Chandler, Arizona |
Authorized Official Name and Position | Richard K Le (PRESIDENT) |
Authorized Official Contact | 4807266632 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Fountains Family Care, P.c. 3930 S Alma School Rd Ste 1 Chandler AZ 85248-4510 Ph: (480) 726-6632 | Fountains Family Care, P.c. 3930 S Alma School Rd Ste 1 Chandler AZ 85248-4510 Ph: (480) 726-6632 |
NPI Number | 1104004183 |
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Provider Enumeration Date | 02/01/2008 |
Last Update Date | 04/08/2015 |
Medicare PECOS PAC ID | 4880608710 |
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Medicare Enrollment ID | O20060131000427 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104004183 | NPI | - | NPPES |
989527 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
2085R0202X | Radiology - Diagnostic Radiology | (* (Not Available)) | Secondary |
Provider Name | Sun H Jones |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124091756 PECOS PAC ID: 2365436128 Enrollment ID: I20040413001729 |
Provider Name | Richard K Le |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1851393003 PECOS PAC ID: 0749294676 Enrollment ID: I20060206000279 |
Provider Name | Xuan Vu |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1285842054 PECOS PAC ID: 3173690385 Enrollment ID: I20080930000039 |
Provider Name | Nadeem Husain |
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Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1154406775 PECOS PAC ID: 4789720749 Enrollment ID: I20100122000211 |
Provider Name | Robert M Ellis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902284599 PECOS PAC ID: 6608183637 Enrollment ID: I20150923001599 |
Provider Name | Phung K Nguyen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912446063 PECOS PAC ID: 5799056057 Enrollment ID: I20171011002976 |
Provider Name | Tyanne T Van |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952808800 PECOS PAC ID: 6608131917 Enrollment ID: I20180809006129 |
Provider Name | Thu Van Thi Tran |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700476280 PECOS PAC ID: 8820403165 Enrollment ID: I20210218000440 |
Provider Name | Linh Hue Tran |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447876560 PECOS PAC ID: 0143636423 Enrollment ID: I20210311000725 |
Provider Name | Anisha Antony |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033995154 PECOS PAC ID: 7618324401 Enrollment ID: I20231116001201 |
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