Pebble Creek Medical Group Pllc

LBN: Pebble Creek Medical Group Pllc
Pebble Creek Medical Group Pllc is an health care organization with primary practice located at 700 N Estrella Pkwy # 130 , Goodyear AZ 85338-9271. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Pebble Creek Medical Group Pllc can be contacted via phone (623) 322-2144, or through Bommakanti, Sanjay via phone (623) 337-6897.

Contact Information

Primary practice address
700 N Estrella Pkwy # 130 Goodyear AZ 85338-9271
Phone: (623) 322-2144
Fax: (623) 322-1165
Website:
Map and Directions
Authorized official contact:
Name: Bommakanti, Sanjay Doctor of Medicine (MD)
Phone: (623) 337-6897

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 37252 Arizona

Profile Details

NPI number 1790213064
LBN Legal business name Pebble Creek Medical Group Pllc
DBA Doing business as
Authorized official Bommakanti, Sanjay Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 31st, 2017
Last updated May 31st, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790213064 NPPES
Arizona MEDICAID 281108

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