| Citizens Integrated Family Practice Llc | |
|
288 N Ironwood Dr Ste 112 Apache Junction AZ 85120-3830 | |
| (515) 867-1918 | |
| Not Available |
| Full Name | Citizens Integrated Family Practice Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 288 N Ironwood Dr Ste 112, Apache Junction, Arizona |
| Authorized Official Name and Position | Noah Kipkorir Sang (ADMINISTRATOR) |
| Authorized Official Contact | 4804061132 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Citizens Integrated Family Practice Llc 1530 E Williams Field Rd Ste 201 Gilbert AZ 85295-1825 Ph: () - | Citizens Integrated Family Practice Llc 288 N Ironwood Dr Ste 112 Apache Junction AZ 85120-3830 Ph: (515) 867-1918 |
| NPI Number | 1285305417 |
|---|---|
| Provider Enumeration Date | 09/27/2021 |
| Last Update Date | 10/12/2022 |
| Medicare PECOS PAC ID | 3274922380 |
|---|---|
| Medicare Enrollment ID | O20220126000603 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285305417 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Deana D O'gorman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962668228 PECOS PAC ID: 9234299827 Enrollment ID: I20160114003050 |
| Provider Name | Noah Kipkorir Sang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457839896 PECOS PAC ID: 1153674999 Enrollment ID: I20181025000561 |
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