ARIZONA CITY HEALTH ASSOCIATES, INC. (ARIZONA CITY HEALTH ASSOCIATES) - NPI NUMBER 1972940237

Summary

Provider Name: ARIZONA CITY HEALTH ASSOCIATES, INC. (ARIZONA CITY HEALTH ASSOCIATES)

NPI Number: 1972940237

Clasification: Family Medicine (207QA0505X)

Specialization: Adult Medicine

Address:
13060 SOUTH SUNLAND GIN ROAD
ARIZONA CITY, AZ
ZIP 85123

Phone Number: (520) 350-7011



Detailed Information

ARIZONA CITY HEALTH ASSOCIATES, INC. is an adult family physician in Arizona City, AZ. The provider is definition to come. The assigned NPI number for this provider is 1972940237 and is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Arizona City Health Associates.

The provider's business address is:

13060 SOUTH SUNLAND GIN ROAD
ARIZONA CITY, AZ
ZIP 85123
Phone: (520) 350-7011

The provider's authorized official is Samuel Efrain Sanchez .
The authorized official title is Ceo and has the following contact phone number (562) 745-8863.

The enumeration date for this NPI number is 5/28/2013 and was last updated on 5/28/2013.

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207QA0505X Family Medicine Adult Medicine 005911 AZ No
2 207Q00000X Family Medicine 005911 AZ Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 1780693861 OTHER CA NPI

NPI Record

No. Field Name Field Value
1 NPI 1972940237
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name ARIZONA CITY HEALTH ASSOCIATES, INC.
5 Provider Other Organization Name ARIZONA CITY HEALTH ASSOCIATES
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 13060 SOUTH SUNLAND GIN ROAD
8 Provider Business Practice Location Address City Name ARIZONA CITY
9 Provider Business Practice Location Address State Name AZ
10 Provider Business Practice Location Address Postal Code 85123
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 5203507011
13 Provider Enumeration Date 5/28/2013
14 Last Update Date 5/28/2013
15 Authorized Official Last Name SANCHEZ
16 Authorized Official First Name SAMUEL
17 Authorized Official Middle Name EFRAIN
18 Authorized Official Title or Position CEO
19 Authorized Official Telephone Number 5627458863
20 Healthcare Provider Taxonomy Code 1 207QA0505X
21 Provider License Number 1 005911
22 Provider License Number State Code 1 AZ
23 Healthcare Provider Primary Taxonomy Switch 1 N
24 Healthcare Provider Taxonomy Code 2 207Q00000X
25 Provider License Number 2 005911
26 Provider License Number State Code 2 AZ
27 Healthcare Provider Primary Taxonomy Switch 2 Y
28 Other Provider Identifier 1 1780693861
29 Other Provider Identifier Type Code 1 01
30 Other Provider Identifier State 1 CA
31 Other Provider Identifier Issuer 1 NPI
32 Is Organization Subpart N
33 Authorized Official Name Prefix Text DR.
34 Authorized Official Credential Text D.O.
35 Healthcare Provider Taxonomy Group 1 193400000X MULTIPLE SINGLE SPECIALTY GROUP
36 Healthcare Provider Taxonomy Group 2 193400000X MULTIPLE SINGLE SPECIALTY GROUP

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This page was last updated on: 9/11/2014
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