Provider Demographics
NPI:1194856989
Name:ESTRELLA WOMEN'S HEALTH CENTER PC
Entity type:Organization
Organization Name:ESTRELLA WOMEN'S HEALTH CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LENA
Authorized Official - Middle Name:F
Authorized Official - Last Name:REDONDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-846-7558
Mailing Address - Street 1:10240 W INDIAN SCHOOL RD.
Mailing Address - Street 2:BLD 2 STE 140
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037
Mailing Address - Country:US
Mailing Address - Phone:623-846-7558
Mailing Address - Fax:623-846-1674
Practice Address - Street 1:10240 W INDIAN SCHOOL RD
Practice Address - Street 2:BLD 2 STE 140
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-5904
Practice Address - Country:US
Practice Address - Phone:623-846-7558
Practice Address - Fax:623-846-1674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZG68667Medicare UPIN
AZI42218Medicare UPIN
AZZWCJDJMedicare PIN
AZC99254Medicare UPIN
AZE00209Medicare UPIN
AZE82241Medicare UPIN
AZI16304Medicare UPIN