=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053211854
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEDICAL CONCIERGE BENEFITS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/06/2026
-----------------------------------------------------
Last Update Date | 11/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CALLEJON IGNACIO ZARAGOZA ENTRE CALLE 11 Y 12 CLINICA Q COLONIA COMERCIAL
-----------------------------------------------------
City | SAN LUIS RIO COLORADO
-----------------------------------------------------
State | SONORA
-----------------------------------------------------
Zip | 83449
-----------------------------------------------------
Country | MX
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | P.O. BOX 14797
-----------------------------------------------------
City | SAN LUIS
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85349
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-713-3561
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF OF OPERATIONS
-----------------------------------------------------
Name | GABRIELA GARCIA BLAS
-----------------------------------------------------
Credential | B.S. BUSINESS ADMINI
-----------------------------------------------------
Telephone | 526-535-1834
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM1300X
-----------------------------------------------------
Taxonomy Name | Multi-Specialty Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------