Healthcare Provider Details

I. General information

NPI: 1730315144
Provider Name (Legal Business Name): TOTAL PRIMARY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2009
Last Update Date: 07/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9188 E SAN SALVADOR DR SUITE 201
SCOTTSDALE AZ
85258-5562
US

IV. Provider business mailing address

9188 E SAN SALVADOR DR SUITE 201
SCOTTSDALE AZ
85258-5562
US

V. Phone/Fax

Practice location:
  • Phone: 480-305-5640
  • Fax: 480-361-5904
Mailing address:
  • Phone: 480-305-5640
  • Fax: 480-361-5904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number4509
License Number StateAZ

VIII. Authorized Official

Name: DR. MICHAEL AHMANN
Title or Position: PRESIDENT
Credential: D.O.
Phone: 480-305-5640