| Aspen Medical, Pllc | |
|
4540 E Baseline Rd Ste 119 Mesa AZ 85206-4617 | |
| (480) 628-2296 | |
| Not Available |
| Full Name | Aspen Medical, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 4540 E Baseline Rd Ste 119, Mesa, Arizona |
| Authorized Official Name and Position | David Farnsworth (OWNER, AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 4806282996 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspen Medical, Pllc 4540 E Baseline Rd Ste 119 Mesa AZ 85206-4617 Ph: () - | Aspen Medical, Pllc 4540 E Baseline Rd Ste 119 Mesa AZ 85206-4617 Ph: (480) 628-2296 |
| NPI Number | 1013542240 |
|---|---|
| Provider Enumeration Date | 03/09/2020 |
| Last Update Date | 11/03/2021 |
| Medicare PECOS PAC ID | 8224469432 |
|---|---|
| Medicare Enrollment ID | O20200502000031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013542240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Julianne C Magdaleno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447665815 PECOS PAC ID: 2466672274 Enrollment ID: I20140930000244 |
| Provider Name | Lorraine D Fajardo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669975876 PECOS PAC ID: 3072851187 Enrollment ID: I20200506002766 |
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