| Veracian Healthcare Plc | |
|
1301 S Crismon Rd Mesa AZ 85209-3767 | |
| (480) 275-4998 | |
| (480) 275-4998 |
| Full Name | Veracian Healthcare Plc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1301 S Crismon Rd, Mesa, Arizona |
| Authorized Official Name and Position | Sai Lakshmi V Chandran (DIRECTOR) |
| Authorized Official Contact | 4802754998 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Veracian Healthcare Plc 2999 E Linda Ln Gilbert AZ 85234-6371 Ph: (480) 275-4998 | Veracian Healthcare Plc 1301 S Crismon Rd Mesa AZ 85209-3767 Ph: (480) 275-4998 |
| NPI Number | 1063647733 |
|---|---|
| Provider Enumeration Date | 05/23/2009 |
| Last Update Date | 09/24/2010 |
| Medicare PECOS PAC ID | 2769535582 |
|---|---|
| Medicare Enrollment ID | O20090727000652 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063647733 | NPI | - | NPPES |
| 431366 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 33186 (Arizona) | Primary |
| Provider Name | Sai L Chandran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437123593 PECOS PAC ID: 7911950969 Enrollment ID: I20050302000162 |
| Provider Name | Jismi Theeyattuveli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285229534 PECOS PAC ID: 0446655625 Enrollment ID: I20210826000869 |
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