Healthcare Provider Details

I. General information

NPI: 1174440150
Provider Name (Legal Business Name): ALLIANCE MEDICAL SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42104 N VENTURE DR STE D118
ANTHEM AZ
85086-3837
US

IV. Provider business mailing address

42104 N VENTURE DR STE D118
ANTHEM AZ
85086-3837
US

V. Phone/Fax

Practice location:
  • Phone: 623-505-6565
  • Fax: 623-551-5567
Mailing address:
  • Phone: 623-505-6565
  • Fax: 623-551-5567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALICIA BAER
Title or Position: PRACTICE MANAGER
Credential:
Phone: 623-552-3756