Clinica Medica Familiar San Gabriel, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CLINICA MEDICA FAMILIAR SAN GABRIEL, LLC

Practice address

4515 S McClintock Dr Ste 115
Tempe, AZ 85282-7381

Phone

(480) 780-0690

Fax

(480) 831-0415

NPI assigned

Feb 22, 2024

Organization subpart

No

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

Authorized official

Name

Marie E Bentz, DNP, FNP-CNPI 1548850134

Title

Owner

Phone

(714) 465-0875

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 1

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

• Marie Elianthe Bentz, FNP

  • Family Nurse Practitioner
  • Orange, CA
  • NPI 1548850134

  AZ, Multi-Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1708560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1609632298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 S MCCLINTOCK DR STE 115",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827381",
            "telephone_number": "480-780-0690",
            "fax_number": "480-831-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 S MCCLINTOCK DR STE 115",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827381",
            "telephone_number": "480-780-0690",
            "fax_number": "480-831-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA MEDICA FAMILIAR SAN GABRIEL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-22",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "BENTZ",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-465-0875",
        "authorized_official_credential": "DNP, FNP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clear Path Wellness LLC
• Jolee R Clement
• John Jay Cleveland, MT-BC
• Clin-Path Diagnostics, LLC
• Jami A Cline, APRN
• Clinical Research Advantage, Inc.
• Kelcie Clinkenbeard, MYTP
• Darren Clonts
• Kelly Clough, N.M.D.
• Faith E Coats, ND

• Family Medicine Physician in Tempe, AZ
• Providers in Tempe, 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 Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.