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GRAND WEST FAMILY PRACTICE AND WELLNESS LLC NPI 1740055599


NPI Information

NPI: 1740055599
Provider Name: GRAND WEST FAMILY PRACTICE AND WELLNESS LLC

Doing Business As: GRAND WEST FAMILY PRACTICE AND WELLNESS LLC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 03D2294542

Address:
13000 N 103RD AVE STE 77
SUN CITY, AZ
ZIP 85351
Phone: (480) 284-5650
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GRAND WEST FAMILY PRACTICE AND WELLNESS LLC is a family medicine in Sun City, AZ. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. GRAND WEST FAMILY PRACTICE AND WELLNESS LLC NPI is 1740055599. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Grand West Family Practice And Wellness Llc.

The provider's business location address is:

13000 N 103RD AVE STE 77
SUN CITY, AZ
ZIP 85351-057
Phone: (480) 284-5650
Fax: (480) 284-6431

The provider's authorized official is Shelly Tellman .
The authorized official title is Owner/manager and has the following contact phone number (623) 824-5017.

The CLIA number assigned to this NPI record is 03D2294542 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/21/2023 and was last updated on 2/6/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.