| Live Well Family Medicine Plc | |
|
655 S Dobson Rd Suite B-115 Chandler AZ 85224-5667 | |
| (480) 800-3561 | |
| (480) 800-3562 |
| Full Name | Live Well Family Medicine Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 655 S Dobson Rd, Chandler, Arizona |
| Authorized Official Name and Position | Norma L Perales (OWNER) |
| Authorized Official Contact | 4808003561 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Well Family Medicine Plc 655 S Dobson Rd Suite B-115 Chandler AZ 85224-5667 Ph: (480) 800-3561 | Live Well Family Medicine Plc 655 S Dobson Rd Suite B-115 Chandler AZ 85224-5667 Ph: (480) 800-3561 |
| NPI Number | 1740698026 |
|---|---|
| Provider Enumeration Date | 07/30/2014 |
| Last Update Date | 07/30/2014 |
| Medicare PECOS PAC ID | 8325265762 |
|---|---|
| Medicare Enrollment ID | O20140808001110 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740698026 | NPI | - | NPPES |
| 508572 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 43025 (Arizona) | Primary |
| Provider Name | Martin J Hernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245253707 PECOS PAC ID: 3173502549 Enrollment ID: I20040719000724 |
| Provider Name | Norma L Perales |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457405953 PECOS PAC ID: 2567556137 Enrollment ID: I20100607000115 |
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