Jessica Blanco Md Pc | |
5505 W Chandler Blvd Ste.#b-13 Chandler AZ 85226-3683 | |
(480) 361-4780 | |
(480) 361-4781 |
Full Name | Jessica Blanco Md Pc |
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Speciality | Family Medicine |
Location | 5505 W Chandler Blvd, Chandler, Arizona |
Authorized Official Name and Position | Jessica Blanco (OWNER) |
Authorized Official Contact | 4803614780 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Jessica Blanco Md Pc 5505 W Chandler Blvd Ste.#b-13 Chandler AZ 85226-3683 Ph: (480) 361-4780 | Jessica Blanco Md Pc 5505 W Chandler Blvd Ste.#b-13 Chandler AZ 85226-3683 Ph: (480) 361-4780 |
NPI Number | 1669642401 |
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Provider Enumeration Date | 03/07/2008 |
Last Update Date | 10/01/2024 |
Medicare PECOS PAC ID | 1658356324 |
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Medicare Enrollment ID | O20110115000085 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669642401 | NPI | - | NPPES |
764284 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Jessica A Blanco |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1467446377 PECOS PAC ID: 6901881671 Enrollment ID: I20110115000091 |
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