| Community Primary Care Llc | |
|
13624 W Camino Del Sol Ste 150 Sun City West AZ 85375-3405 | |
| (623) 328-7087 | |
| (623) 218-1337 |
| Full Name | Community Primary Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13624 W Camino Del Sol Ste 150, Sun City West, Arizona |
| Authorized Official Name and Position | Aziz Mallik (MANAGING PARTNER) |
| Authorized Official Contact | 6233287087 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Primary Care Llc 12409 W Indian School Rd Ste A108 Avondale AZ 85392-9503 Ph: (623) 328-7087 | Community Primary Care Llc 13624 W Camino Del Sol Ste 150 Sun City West AZ 85375-3405 Ph: (623) 328-7087 |
| NPI Number | 1659041580 |
|---|---|
| Provider Enumeration Date | 09/13/2021 |
| Last Update Date | 12/22/2021 |
| Medicare PECOS PAC ID | 2860886447 |
|---|---|
| Medicare Enrollment ID | O20220224001039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659041580 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Melanie N Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174018220 PECOS PAC ID: 4284983222 Enrollment ID: I20181214002950 |
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