| Southwest Primary Care Ltd | |
|
3200 N Dobson Rd Suite F-5 Chandler AZ 85224-9601 | |
| (630) 329-9816 | |
| Not Available |
| Full Name | Southwest Primary Care Ltd |
|---|---|
| Speciality | Family Medicine |
| Location | 3200 N Dobson Rd, Chandler, Arizona |
| Authorized Official Name and Position | Manu Lonial (PRESIDENT) |
| Authorized Official Contact | 6303299816 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Primary Care Ltd 5932 E Phelps Rd Scottsdale AZ 85254-9223 Ph: (630) 329-9816 | Southwest Primary Care Ltd 3200 N Dobson Rd Suite F-5 Chandler AZ 85224-9601 Ph: (630) 329-9816 |
| NPI Number | 1942691399 |
|---|---|
| Provider Enumeration Date | 02/06/2015 |
| Last Update Date | 02/06/2015 |
| Medicare PECOS PAC ID | 0840510251 |
|---|---|
| Medicare Enrollment ID | O20150527001478 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942691399 | NPI | - | NPPES |
| 19770524 | Other | AZ | CORPORATION NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 43225 (Arizona) | Primary |
| Provider Name | Manu Lonial |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063553543 PECOS PAC ID: 0749202208 Enrollment ID: I20110120000449 |
| Provider Name | Brittney T Mahnke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265091276 PECOS PAC ID: 5193150308 Enrollment ID: I20200116001432 |
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