Provider Demographics
NPI:1154741957
Name:CENTRO DE SALUD FAMILIAR
Entity type:Organization
Organization Name:CENTRO DE SALUD FAMILIAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:NMD
Authorized Official - Phone:602-241-9105
Mailing Address - Street 1:2121 W INDIAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-4908
Mailing Address - Country:US
Mailing Address - Phone:602-241-9105
Mailing Address - Fax:602-241-9104
Practice Address - Street 1:2121 W INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-4908
Practice Address - Country:US
Practice Address - Phone:602-241-9105
Practice Address - Fax:602-241-9104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-18
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14-1432261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care