OLD PUEBLO MOBILE MEDICINE LLC (NPI# 1609493402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609493402 |
| Entity Type | Organization |
| Organization Name | OLD PUEBLO MOBILE MEDICINE LLC |
| Practice Address |
9721 E Colette St Tucson AZ 85748-2756 |
| Practice Telephone | 5203141008 |
| Practice Fax Number | 6822012429 |
| Mailing Telephone | 5203141008 |
| Mailing Fax Number | 6822012429 |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2020-06-29 |
| Authorized Official Name | MRS. AMANDA A DAVIS (NURSE PRACTITIONER) |
| Authorized Official Telephone | 5208224423 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
9721 E COLETTE ST |
| City | TUCSON |
| State | AZ |
| Zip Code | 85748-2756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750892246 | Intermountain Health Center, Inc. | Community/Behavioral Health | 994 S. Harrison Road, Tucson, AZ 85748 | 2017-10-24 |
| 1083125587 | Intermountain Health Center, Inc. | Community/Behavioral Health | 1020 South Harrison Road, Tucson, AZ 85748 | 2017-10-24 |
| 1730699679 | Southern Arizona Urgent Care, LLC | Clinic/Center | 1040 S. Harrison Rd, Ste. 120, Tucson, AZ 85748 | 2017-10-05 |
| 1730609652 | Kathleen R Hizer | Social Worker | 2051 S Calle Mesa Del Oso, Tucson, AZ 85748 | 2017-06-21 |
| 1629453170 | Augustin Igulu Lukwango | Contractor | 994 S Harrison Road, Tucson, AZ 85748 | 2015-07-27 |
| 1588051353 | Cheol M. Choi | Dentist | 9565 E 22nd St Ste 143, Tucson, AZ 85748 | 2015-04-20 |
| 1295168722 | Sandra Lee Chmiel | Veterinarian | 9855 E Speedway Blvd, Unit 12103, Tucson, AZ 85748 | 2013-08-20 |
| 1134420649 | Leslie Cicalese | Pharmacist | 1145 South Harrison Rd, Tucson, AZ 85748 | 2010-11-15 |
| 1760711923 | Enrique Romero | Specialist/Technologist, Other | 10339 E Cowhead Saddle Ln, Tucson, AZ 85748 | 2009-12-17 |
| 1437348349 | Audrey Wolfel | Nurse Practitioner | 10315 Broadway Boulevard, Tucson, AZ 85748 | 2007-10-16 |
| Find all providers in zip 85748 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023641792 | Amy Fitzgerald | Family Medicine | 2442 E Blue Diamond Dr, Tucson, AZ 85718-6691 | 2020-02-20 |
| 1578194866 | Keto Consults LLC | Family Medicine | 7469 E Broadway Blvd Ste A, Tucson, AZ 85710-1487 | 2020-01-27 |
| 1992343362 | Laurie Anne Mcmahon | Family Medicine | 899 N. Wilmot, Building B, Tucson, AZ 85711 | 2019-12-17 |
| 1215440326 | Maryelizabeth Hunter | Family Medicine | 6890 E Sunrise Dr Ste 120-176, Tucson, AZ 85750-0738 | 2017-11-10 |
| 1164963591 | Shohei Sowid-shima | Family Medicine | 6860 E Sunrise Dr Ste 100, Tucson, AZ 85750-0733 | 2017-03-18 |
| 1588024178 | Norma A. Price | Family Medicine | 602 W Ajo Way, Tucson, AZ 85713-6046 | 2016-02-25 |
| 1801279617 | Mitul Vinodkumar Mehta | Family Medicine | 2355 N Wyatt Dr Ste 101, Tucson, AZ 85712-2120 | 2015-06-30 |
| 1649652280 | Angela Suhale Puthenveetil | Family Medicine | 8020 N Cortaro Rd Ste 150, Tucson, AZ 85743-8305 | 2015-06-19 |
| 1366821068 | Renewed Medical Health | Family Medicine | 3382 E Speedway Blvd, Tucson, AZ 85716-3936 | 2015-05-27 |
| 1174902936 | Steven Aussenberg | Family Medicine | 4655 N Placita Roca Blanca, Tucson, AZ 85718-7476 | 2015-05-27 |
| Find all providers in TUCSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.