Az Wellness Clinica Familiar LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

AZ WELLNESS CLINICA FAMILIAR LLC

Practice address

10645 N 43Rd Ave
Phoenix, AZ 85029-3944

Phone

(602) 370-2920

NPI assigned

Aug 16, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Joseph Gutierrez, MDNPI 1538143300

Title

Medical Director

Phone

(480) 433-9920

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph M Gutierrez, M.D.

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1538143300
  Medicare reassignment NPD Authorized official
• Lianet Lantigua Ponce de Leon

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1265122584
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1255163382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10645 N 43RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10645 N 43RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293944",
            "telephone_number": "602-370-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ WELLNESS CLINICA FAMILIAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "480-433-9920",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Arash Azamiyan
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• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.