NPIMap

Organization Active NPI

Estrella Family Medical, LLC.

  • Family Medicine Physician
  • Goodyear, AZ
National Provider Identifier
1669593398
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ESTRELLA FAMILY MEDICAL, LLC.
Practice address
750 N. Estrella Parkway
Suite 20
Goodyear, AZ 85338
Phone
(623) 298-4642
Fax
(623) 925-9193
NPI assigned
Apr 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Authorized official

Name
Mr. Bernard Goodman, M.H.A.
Title
Chief Executive Officer
Phone
(623) 298-4642

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

750 N. Estrella Parkway
Suite 20
Goodyear, AZ 85338

Mailing address

750 N Estrella Pkwy
Suite 20
Goodyear, AZ 85338-9272
Phone (623) 298-4642

National Provider Directory

National Provider Directory

Locations

750 N Estrella Pkwy
Ste 20
Goodyear, AZ 85338
Phone (623) 298-4642

750 N Estrella Pkwy
Ste 3B
Goodyear, AZ 85338
Phone (623) 845-8200

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1669593398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N ESTRELLA PKWY",
            "address_2": "SUITE 20",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853389272",
            "telephone_number": "623-298-4642",
            "fax_number": "623-925-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N. ESTRELLA PARKWAY",
            "address_2": "SUITE 20",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "85338",
            "telephone_number": "623-298-4642",
            "fax_number": "623-925-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESTRELLA FAMILY MEDICAL, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "623-298-4642",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.H.A."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.