Leila Peterson, Pllc | |
2680 S Val Vista Dr Ste 140 Gilbert AZ 85295-1621 | |
(435) 757-8824 | |
Not Available |
Full Name | Leila Peterson, Pllc |
---|---|
Speciality | Family Medicine |
Location | 2680 S Val Vista Dr Ste 140, Gilbert, Arizona |
Authorized Official Name and Position | Leila Peterson (OWNER) |
Authorized Official Contact | 4357578824 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Leila Peterson, Pllc 2680 S Val Vista Dr Ste 140 Gilbert AZ 85295-1621 Ph: () - | Leila Peterson, Pllc 2680 S Val Vista Dr Ste 140 Gilbert AZ 85295-1621 Ph: (435) 757-8824 |
NPI Number | 1700413978 |
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Provider Enumeration Date | 03/26/2020 |
Last Update Date | 06/25/2020 |
Medicare PECOS PAC ID | 5890126908 |
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Medicare Enrollment ID | O20200505001776 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700413978 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Leila King Peterson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1952535056 PECOS PAC ID: 4880845395 Enrollment ID: I20200505001749 |
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