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NPI Code Detail

MEDICARE: DESERT FAMILY PHYSICIANS PC

MEDICARE: DESERT FAMILY PHYSICIANS PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician1808AZ

General Provider Information

NPI Number : 1528118668
Entity Type Code : Organization
Provider Name (Legal Business Name) : DESERT FAMILY PHYSICIANS PC
Provider Business Mailing Address
First Line : 5520 E MAIN ST STE 4
Second Line :
City : MESA
State : AZ
Zip : 85205-8793
Country : US
Telephone Number : 480-832-1992
Fax Number : 480-830-2402
Provider Business Practice Location Address
First Line : 5520 E MAIN ST STE 4
Second Line :
City : MESA
State : AZ
Zip : 85205-8793
Country : US
Telephone Number : 480-832-1992
Fax Number : 480-830-2402
Authorized Official
Title or Position : PRESIDENT
Name : CESAR M RODARTE
Credential : D.O
Telephone Number : 480-832-1992
Provider Enumeration Date : 01/11/2007
Last Update Date : 01/22/2013

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Directions to “DESERT FAMILY PHYSICIANS PC ” Practice Location

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