| Lake Pleasant Internal Medicine Plc | |
|
9059 W Lake Pleasant Pkwy Ste C-320 Peoria AZ 85382-8336 | |
| (623) 455-3317 | |
| (623) 256-6551 |
| Full Name | Lake Pleasant Internal Medicine Plc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9059 W Lake Pleasant Pkwy, Peoria, Arizona |
| Authorized Official Name and Position | Joan Frances Chua (MANAGER) |
| Authorized Official Contact | 6234553317 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Pleasant Internal Medicine Plc 9059 W Lake Pleasant Pkwy Ste C-320 Peoria AZ 85382-8336 Ph: (623) 455-3317 | Lake Pleasant Internal Medicine Plc 9059 W Lake Pleasant Pkwy Ste C-320 Peoria AZ 85382-8336 Ph: (623) 455-3317 |
| NPI Number | 1891808085 |
|---|---|
| Provider Enumeration Date | 08/15/2006 |
| Last Update Date | 11/30/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891808085 | NPI | - | NPPES |
| 795974 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 31697 (Arizona) | Primary |
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