| Santibanez Pac Idaho | |
|
840 E Elva St Idaho Falls ID 83401-2801 | |
| (208) 523-4795 | |
| Not Available |
| Full Name | Santibanez Pac Idaho |
|---|---|
| Speciality | Internal Medicine |
| Location | 840 E Elva St, Idaho Falls, Idaho |
| Authorized Official Name and Position | Julie Roser (VP OF OPERATIONS) |
| Authorized Official Contact | 7752220045 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Santibanez Pac Idaho 10775 Double R Blvd Reno NV 89521-8956 Ph: () - | Santibanez Pac Idaho 840 E Elva St Idaho Falls ID 83401-2801 Ph: (208) 523-4795 |
| NPI Number | 1346015948 |
|---|---|
| Provider Enumeration Date | 11/24/2023 |
| Last Update Date | 11/24/2023 |
| Medicare PECOS PAC ID | 2961846209 |
|---|---|
| Medicare Enrollment ID | O20240215000080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346015948 | NPI | - | NPPES |
| Provider Name | Jorge Santibanez |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568446672 PECOS PAC ID: 9739179847 Enrollment ID: I20170830003648 |
| Provider Name | James A Thomson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396070611 PECOS PAC ID: 4183870744 Enrollment ID: I20190226002619 |
| Provider Name | Christine Christensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558060202 PECOS PAC ID: 6800256165 Enrollment ID: I20230718002335 |
| Provider Name | Jesse Twu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508216581 PECOS PAC ID: 5193013027 Enrollment ID: I20230919003052 |
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