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General NPI Number Information
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NPI Number | 1942691399
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Entity Type | Organization
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Legal Business Name | SOUTHWEST PRIMARY CARE LTD
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Dates
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Enumeration Date | 02/06/2015
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Last Update Date | 02/06/2015
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Provider Practice Location Address
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Address Line | 3200 N DOBSON RD SUITE F-5
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City | CHANDLER
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State | AZ
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Zip | 85224-9601
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Country | US
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Telephone | 630-329-9816
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Fax |
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Provider Business Mailing Address
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Address Line | 5932 E PHELPS RD
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-9223
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Country | US
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Telephone | 630-329-9816
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MANU LONIAL
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Credential | M.D.
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Telephone | 630-329-9816
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 43225
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License Number State | AZ
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