NPIMap

Organization Active NPI

Chambo Wellness Center, LLC

  • Family Medicine Physician
  • Glendale, AZ
National Provider Identifier
1699942268
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3615 Issued in AZ
Legal business name
CHAMBO WELLNESS CENTER, LLC
Practice address
4925 W Bell Rd
Suite C7
Glendale, AZ 85308-3427
Phone
(602) 298-2653
Fax
(602) 298-2686
NPI assigned
May 13, 2008
Last updated
May 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Authorized official

Name
Gregory A Bode, DO
Title
Medical Dircector
Phone
(602) 298-2653

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3615 AZ Primary

Addresses

Primary practice location

4925 W Bell Rd
Suite C7
Glendale, AZ 85308-3427

Mailing address

6740 W Deer Valley Rd
Suite D107-255
Glendale, AZ 85310-5953
Phone (602) 298-2653

National Provider Directory

National Provider Directory
Tax ID family
Chambo Wellness Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1699942268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6740 W DEER VALLEY RD",
            "address_2": "SUITE D107-255",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853105953",
            "telephone_number": "602-298-2653",
            "fax_number": "602-298-2686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4925 W BELL RD",
            "address_2": "SUITE C7",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083427",
            "telephone_number": "602-298-2653",
            "fax_number": "602-298-2686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMBO WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "BODE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRCECTOR",
        "authorized_official_telephone_number": "602-298-2653",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "3615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.