Lake Pleasant Internal Medicine PLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

31697 Issued in AZ

Legal business name

LAKE PLEASANT INTERNAL MEDICINE PLC

Practice address

9059 W Lake Pleasant Pkwy
Ste C-320
Peoria, AZ 85382-8336

Phone

(623) 455-3317

Fax

(623) 256-6551

NPI assigned

Aug 15, 2006

Organization subpart

No

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

Authorized official

Name

Joan Frances Chua, MD

Title

Manager

Phone

(623) 455-3317

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1891808085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9059 W LAKE PLEASANT PKWY",
            "address_2": "STE C-320",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853828336",
            "telephone_number": "623-455-3317",
            "fax_number": "623-256-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9059 W LAKE PLEASANT PKWY",
            "address_2": "STE C-320",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853828336",
            "telephone_number": "623-455-3317",
            "fax_number": "623-256-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE PLEASANT INTERNAL MEDICINE PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "CHUA",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "FRANCES",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "623-455-3317",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "31697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "795974",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.