Healthcare Provider Details

I. General information

NPI: 1407876972
Provider Name (Legal Business Name): FIRST CHOICE FAMILY CARE, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10440 E RIGGS RD STE 201
SUN LAKES AZ
85248-7755
US

IV. Provider business mailing address

PO BOX 16455
MESA AZ
85211-6455
US

V. Phone/Fax

Practice location:
  • Phone: 480-615-2000
  • Fax: 480-962-0523
Mailing address:
  • Phone: 480-615-2000
  • Fax: 480-962-0523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DIANE M VONFLUE
Title or Position: CFO
Credential:
Phone: 480-615-2070