| Gmc Healthcare | |
|
10250 N 124th St Scottsdale AZ 85259-5201 | |
| (602) 603-4660 | |
| (602) 860-6050 |
| Full Name | Gmc Healthcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 10250 N 124th St, Scottsdale, Arizona |
| Authorized Official Name and Position | Randy Mallari (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 6029088580 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gmc Healthcare 10250 N 124th St Scottsdale AZ 85259-5201 Ph: (602) 603-4660 | Gmc Healthcare 10250 N 124th St Scottsdale AZ 85259-5201 Ph: (602) 603-4660 |
| NPI Number | 1659153195 |
|---|---|
| Provider Enumeration Date | 10/19/2023 |
| Last Update Date | 02/24/2024 |
| Medicare PECOS PAC ID | 2062850159 |
|---|---|
| Medicare Enrollment ID | O20240409002728 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659153195 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Jesse Cisneros Jimenez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124745260 PECOS PAC ID: 6608232335 Enrollment ID: I20230601002851 |
| Provider Name | David M Snipper |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1417925249 PECOS PAC ID: 5294701694 Enrollment ID: I20240411003776 |
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