| Avondale Medical Center | |
|
501 W Van Buren St Ste T Avondale AZ 85323 | |
| (623) 932-9905 | |
| (623) 932-6901 |
| Full Name | Avondale Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 501 W Van Buren St Ste T, Avondale, Arizona |
| Authorized Official Name and Position | Jennifer Tafoya (OFFICE MANAGER) |
| Authorized Official Contact | 6239329905 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avondale Medical Center 501 W Van Buren St Ste T Avondale AZ 85323-1307 Ph: (623) 932-9905 | Avondale Medical Center 501 W Van Buren St Ste T Avondale AZ 85323 Ph: (623) 932-9905 |
| NPI Number | 1659415206 |
|---|---|
| Provider Enumeration Date | 02/16/2007 |
| Last Update Date | 02/26/2021 |
| Medicare PECOS PAC ID | 9436225364 |
|---|---|
| Medicare Enrollment ID | O20080829000169 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659415206 | NPI | - | NPPES |
| 894099 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 33419 (Arizona) | Primary |
| Provider Name | Rohit Malhotra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659372225 PECOS PAC ID: 6709841794 Enrollment ID: I20041201000762 |
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