Healthcare Provider Details

I. General information

NPI: 1427362672
Provider Name (Legal Business Name): PRIMARY CARE ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 10/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 E WARNER RD SUITE 101
CHANDLER AZ
85225-1058
US

IV. Provider business mailing address

845 E WARNER RD SUITE 101
CHANDLER AZ
85225-1058
US

V. Phone/Fax

Practice location:
  • Phone: 480-786-5000
  • Fax: 480-786-5050
Mailing address:
  • Phone: 480-786-5000
  • Fax: 480-786-5050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34593
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number30769
License Number StateAZ

VIII. Authorized Official

Name: BIDYA LOHANI-SHARMA
Title or Position: CO-DIRECTOR
Credential: MD
Phone: 480-786-5000