| Chicanos Por La Causa Inc | |
|
6850 W Indian School Rd Phoenix AZ 85033-3300 | |
| (232) 470-4646 | |
| Not Available |
| Full Name | Chicanos Por La Causa Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6850 W Indian School Rd, Phoenix, Arizona |
| Authorized Official Name and Position | Andres Contreras (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Contact | 6022570700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicanos Por La Causa Inc 1112 E. Buckeye Rd. Phoenix AZ 85034 Ph: (602) 257-0700 | Chicanos Por La Causa Inc 6850 W Indian School Rd Phoenix AZ 85033-3300 Ph: (232) 470-4646 |
| NPI Number | 1255416103 |
|---|---|
| Provider Enumeration Date | 10/26/2006 |
| Last Update Date | 08/14/2023 |
| Certification Date | 08/14/2023 |
| Medicare PECOS PAC ID | 4587618285 |
|---|---|
| Medicare Enrollment ID | O20050305000056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255416103 | NPI | - | NPPES |
| 112219 | Medicaid | AZ |
| Provider Name | Brandy A Hammond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659443745 PECOS PAC ID: 0941254718 Enrollment ID: I20050304000607 |
| Provider Name | Rebecca L Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982714416 PECOS PAC ID: 6204861727 Enrollment ID: I20051003000787 |
| Provider Name | Nirva Jean-baptiste |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407279771 PECOS PAC ID: 3577887553 Enrollment ID: I20150122000480 |
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