| Desert Ridge Family Physicians | |
|
20940 N Tatum Blvd #300 Phoenix AZ 85050-4265 | |
| (480) 607-0060 | |
| (480) 607-5809 |
| Full Name | Desert Ridge Family Physicians |
|---|---|
| Speciality | Family Medicine |
| Location | 20940 N Tatum Blvd, Phoenix, Arizona |
| Authorized Official Name and Position | Tiffany M Nelson (MANAGER) |
| Authorized Official Contact | 4806070060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Ridge Family Physicians 20940 N Tatum Blvd #300 Phoenix AZ 85050-4265 Ph: (480) 607-0060 | Desert Ridge Family Physicians 20940 N Tatum Blvd #300 Phoenix AZ 85050-4265 Ph: (480) 607-0060 |
| NPI Number | 1477524916 |
|---|---|
| Provider Enumeration Date | 02/01/2006 |
| Last Update Date | 01/28/2015 |
| Medicare PECOS PAC ID | 9436138708 |
|---|---|
| Medicare Enrollment ID | O20040719001494 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477524916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| Provider Name | Kelly M Luba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740269406 PECOS PAC ID: 1052308947 Enrollment ID: I20040430000940 |
| Provider Name | Tiffany M Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265413033 PECOS PAC ID: 4688653967 Enrollment ID: I20040719001528 |
| Provider Name | Kristin K Lau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467433144 PECOS PAC ID: 5193704476 Enrollment ID: I20040719001549 |
| Provider Name | Edward J Perrin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083673024 PECOS PAC ID: 2163452061 Enrollment ID: I20050819000831 |
| Provider Name | Lisa J Piccione |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356456552 PECOS PAC ID: 9032233192 Enrollment ID: I20111028000126 |
| Provider Name | Patricia L Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164742458 PECOS PAC ID: 1951539063 Enrollment ID: I20140117001380 |
| Provider Name | Emily Edwards Inglhofer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174816730 PECOS PAC ID: 1355569443 Enrollment ID: I20140903001005 |
| Provider Name | Tomas a Acuna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972890648 PECOS PAC ID: 2668793910 Enrollment ID: I20150611001835 |
| Provider Name | Michelle a Jao-velasquez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659514594 PECOS PAC ID: 8921141169 Enrollment ID: I20150921000643 |
| Provider Name | Chelsi MR Hoshiwara |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346733938 PECOS PAC ID: 4587032420 Enrollment ID: I20221123002861 |
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