| |
6739 W Cactus Rd Peoria AZ 85381-5311 | |
(623) 240-1110 | |
(623) 889-0814 |
Full Name | |
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Speciality | Family Medicine |
Location | 6739 W Cactus Rd, Peoria, Arizona |
Authorized Official Name and Position | Keqiang Shen (CHIEF CLINICIAN OFFICER) |
Authorized Official Contact | 6026264473 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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6739 W Cactus Rd Peoria AZ 85381-5311 Ph: (623) 240-1110 | 6739 W Cactus Rd Peoria AZ 85381-5311 Ph: (623) 240-1110 |
NPI Number | 1033507033 |
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Provider Enumeration Date | 12/30/2014 |
Last Update Date | 04/29/2022 |
Identifier | Type | State | Issuer |
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1033507033 | NPI | - | NPPES |
003323 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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