| My Home Doc Llc | |
|
1825 E Northern Ave Ste 105 Phoenix AZ 85020-3953 | |
| (602) 469-9466 | |
| (480) 393-8555 |
| Full Name | My Home Doc Llc |
|---|---|
| Speciality | General Practice |
| Location | 1825 E Northern Ave Ste 105, Phoenix, Arizona |
| Authorized Official Name and Position | Nilesh Patel (CHIEF MEDICAL DIRECTOR) |
| Authorized Official Contact | 6024699466 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| My Home Doc Llc 1825 E Northern Ave Ste 105 Phoenix AZ 85020-3953 Ph: (602) 469-9466 | My Home Doc Llc 1825 E Northern Ave Ste 105 Phoenix AZ 85020-3953 Ph: (602) 469-9466 |
| NPI Number | 1508405077 |
|---|---|
| Provider Enumeration Date | 01/02/2020 |
| Last Update Date | 10/11/2022 |
| Medicare PECOS PAC ID | 4880006733 |
|---|---|
| Medicare Enrollment ID | O20201217000353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508405077 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Nilesh T Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699778167 PECOS PAC ID: 7012908676 Enrollment ID: I20040521000480 |
| Provider Name | William H Mcginnis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275591612 PECOS PAC ID: 5698708683 Enrollment ID: I20050912000054 |
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