| |
17014 W Bell Rd Ste 100 Surprise AZ 85374-2479 | |
(623) 866-4484 | |
(844) 327-6864 |
Full Name | |
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Speciality | Internal Medicine |
Location | 17014 W Bell Rd Ste 100, Surprise, Arizona |
Authorized Official Name and Position | Suzanne Hansen (CHIEF MEDICARE PROGRAM OFFICER) |
Authorized Official Contact | 4158140927 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1 Embarcadero Ctr Fl 19 San Francisco CA 94111-3628 Ph: () - | 17014 W Bell Rd Ste 100 Surprise AZ 85374-2479 Ph: (623) 866-4484 |
NPI Number | 1952896235 |
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Provider Enumeration Date | 06/28/2018 |
Last Update Date | 09/07/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952896235 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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