| Kids And Family Kare Llc | |
|
521 W Thomas Rd Fl 2 Phoenix AZ 85013-4241 | |
| (602) 254-0390 | |
| (888) 846-8757 |
| Full Name | Kids And Family Kare Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 521 W Thomas Rd Fl 2, Phoenix, Arizona |
| Authorized Official Name and Position | Carlos J Lopez (OWNER/MANAGER) |
| Authorized Official Contact | 6022540390 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids And Family Kare Llc 521 W Thomas Rd Fl 2 Phoenix AZ 85013-4241 Ph: (602) 254-0390 | Kids And Family Kare Llc 521 W Thomas Rd Fl 2 Phoenix AZ 85013-4241 Ph: (602) 254-0390 |
| NPI Number | 1508406075 |
|---|---|
| Provider Enumeration Date | 01/13/2020 |
| Last Update Date | 08/12/2024 |
| Medicare PECOS PAC ID | 4486074010 |
|---|---|
| Medicare Enrollment ID | O20201020000907 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508406075 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Carlos J Lopez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952309320 PECOS PAC ID: 3870511629 Enrollment ID: I20051109001213 |
| Provider Name | Eva D Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063917706 PECOS PAC ID: 9436414398 Enrollment ID: I20180523001696 |
| Provider Name | Jose A Santoyo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073097903 PECOS PAC ID: 8921344151 Enrollment ID: I20190109002039 |
| Provider Name | Roxana Ofelia Medina Estrada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437916392 PECOS PAC ID: 5092154955 Enrollment ID: I20240411004677 |
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