| Desert Foothills Family Medicine | |
|
5505 W Chandler Blvd Ste.#b-13 Chandler AZ 85226-3683 | |
| (480) 361-4780 | |
| (480) 361-4781 |
| Full Name | Desert Foothills Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 5505 W Chandler Blvd, Chandler, Arizona |
| Authorized Official Name and Position | Jessica Blanco (OWNER) |
| Authorized Official Contact | 4803614780 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Foothills Family Medicine 5505 W Chandler Blvd Ste.#b-13 Chandler AZ 85226-3683 Ph: (480) 361-4780 | Desert Foothills Family Medicine 5505 W Chandler Blvd Ste.#b-13 Chandler AZ 85226-3683 Ph: (480) 361-4780 |
| NPI Number | 1669642401 |
|---|---|
| Provider Enumeration Date | 03/07/2008 |
| Last Update Date | 03/24/2025 |
| Certification Date | 03/24/2025 |
| Medicare PECOS PAC ID | 1658356324 |
|---|---|
| Medicare Enrollment ID | O20110115000085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669642401 | NPI | - | NPPES |
| 764284 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
| Provider Name | Maura B Tardif |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528216371 PECOS PAC ID: 8527126028 Enrollment ID: I20090916000125 |
| Provider Name | Jessica a Blanco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467446377 PECOS PAC ID: 6901881671 Enrollment ID: I20110115000091 |
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