| Presidio Primary Care Pllc | |
|
1100 S Dobson Rd Chandler AZ 85286-6157 | |
| (480) 505-3595 | |
| (480) 505-3288 |
| Full Name | Presidio Primary Care Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1100 S Dobson Rd, Chandler, Arizona |
| Authorized Official Name and Position | Marie Pimentel (DOCTOR) |
| Authorized Official Contact | 4805053295 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Presidio Primary Care Pllc 1100 S Dobson Rd Suite 100 Chandler AZ 85286-6157 Ph: (480) 347-4300 | Presidio Primary Care Pllc 1100 S Dobson Rd Chandler AZ 85286-6157 Ph: (480) 505-3595 |
| NPI Number | 1841446085 |
|---|---|
| Provider Enumeration Date | 08/07/2008 |
| Last Update Date | 12/29/2008 |
| Medicare PECOS PAC ID | 1153484878 |
|---|---|
| Medicare Enrollment ID | O20090107000178 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841446085 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 22505 (Arizona) | Primary |
| 261QP2300X | Clinic/center - Primary Care | 22574 (Arizona) | Secondary |
| Provider Name | Cynthia G Jordan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548349624 PECOS PAC ID: 1759368574 Enrollment ID: I20040630000528 |
| Provider Name | Rachel Elizabeth Cheney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033603303 PECOS PAC ID: 7214284934 Enrollment ID: I20180725003451 |
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