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Health Care Directory In United States

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Medical Specialty

Professional ID

  • NPI: 1295730539
  • PECOS ID: 3678596186
  • Enrollment ID: I20060111000350
  • Credential(MD, DO, DPM): MD
  • Medical School: Harvard Medical School
  • Medical School Graduation Year: 1994

Hospital Service

  • Hospital CCN1: 030065
  • Business Name (LBN)1: Banner Desert Medical Center
  • Hospital CCN2: 450580
  • Business Name (LBN)2: Houston County Medical Center

Medical Practices

  • Organization Name: Premier Medical Group Llc
  • Group Practice ID assigned by PECOS: 9335132604
  • Number of Group Practice member: 20

Location

  • Address1: 5030 S Mill Ave
  • Address2: Suite D12
  • City: Tempe
  • State: Arizona
  • Zip Code: 85282
  • Phone Number: (480)894-2823

Location

  • Address1: 652 E Warner Rd
  • Address2: Suite 107
  • City: Gilbert
  • State: Arizona
  • Zip Code: 85296
  • Phone Number: (480)539-8680

Medicare

  • Medicare Assignment: Yes
  • Report Quality of Care to Physician Quality Reporting System (PQRS): Yes
  • Used Electronic health record (EHR):