Organization Name: | PACIFIC FAMILY MEDICINE, INC. |
NPI Number: | 1649404153 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NATIVIDAD VERDEJO (PHYSICIAN) |
Mailing Address: | 2360 W Ray Rd Ste 2 Chandler |
State: | AZ US |
Postal Code: | 852243634 |
Phone Number: | 4808553770 |
Fax Number: | 4808557906 |
NPI Enumeration Date: | 05/12/2009 |
NPI Last Update Date: | 01/20/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 22684 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |