Presidio Primary Care PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

22505 Issued in AZ

Legal business name

PRESIDIO PRIMARY CARE PLLC

Practice address

1100 S Dobson Rd
Chandler, AZ 85286-6157

Phone

(480) 505-3595

Fax

(480) 505-3288

NPI assigned

Aug 7, 2008

Last updated

Dec 29, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Marie Pimentel, MD

Title

Doctor

Phone

(480) 505-3295

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230508800000",
    "number": "1841446085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S DOBSON RD",
            "address_2": "SUITE 100",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852866157",
            "telephone_number": "480-347-4300",
            "fax_number": "480-347-4360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S DOBSON RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852866157",
            "telephone_number": "480-505-3595",
            "fax_number": "480-505-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESIDIO PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-07",
        "last_updated": "2008-12-29",
        "status": "A",
        "authorized_official_last_name": "PIMENTEL",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "480-505-3295",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AZ",
            "license": "22574",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AZ",
            "license": "22505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Primary Care Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.