| Ch Specialty Services Az Llc | |
|
13755 N Litchfield Rd Ste 105 Surprise AZ 85379-4288 | |
| (337) 991-9276 | |
| Not Available |
| Full Name | Ch Specialty Services Az Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 13755 N Litchfield Rd Ste 105, Surprise, Arizona |
| Authorized Official Name and Position | Nicole Howard (SR VP OF ADMINISTRATIVE SERVICES) |
| Authorized Official Contact | 3379919276 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ch Specialty Services Az Llc 1509 Dulles Dr Lafayette LA 70506-3718 Ph: (337) 991-9276 | Ch Specialty Services Az Llc 13755 N Litchfield Rd Ste 105 Surprise AZ 85379-4288 Ph: (337) 991-9276 |
| NPI Number | 1982303392 |
|---|---|
| Provider Enumeration Date | 02/24/2023 |
| Last Update Date | 02/24/2023 |
| Medicare PECOS PAC ID | 7214301621 |
|---|---|
| Medicare Enrollment ID | O20230327002334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982303392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Antonio Gamboa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154356780 PECOS PAC ID: 2264468222 Enrollment ID: I20050711000736 |
| Provider Name | Deborah A Copus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699877357 PECOS PAC ID: 8022031855 Enrollment ID: I20060109000048 |
| Provider Name | Diana Mccully |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972973022 PECOS PAC ID: 5991002834 Enrollment ID: I20160321002023 |
| Provider Name | Deborah Koval |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811543317 PECOS PAC ID: 7214369024 Enrollment ID: I20191118000049 |
| Provider Name | Karissa Nawal Alkhafi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598391500 PECOS PAC ID: 5294151270 Enrollment ID: I20200820003495 |
| Provider Name | Margo Ruth Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699365031 PECOS PAC ID: 3779729181 Enrollment ID: I20210416000567 |
| Provider Name | Sara Shayan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629737390 PECOS PAC ID: 1557716693 Enrollment ID: I20231010003489 |
| Provider Name | Seth Six |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164039988 PECOS PAC ID: 3678985645 Enrollment ID: I20231031003772 |
| Provider Name | Eman Yousif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699295733 PECOS PAC ID: 6103198916 Enrollment ID: I20231221003612 |
| Provider Name | Cody Guggenmos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396242731 PECOS PAC ID: 9739514100 Enrollment ID: I20240109004347 |
| Provider Name | Mauricio Pinto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881860724 PECOS PAC ID: 8224286182 Enrollment ID: I20240209001968 |
| Provider Name | Kimberly Dawn Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104502590 PECOS PAC ID: 2163867631 Enrollment ID: I20240224000455 |
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