# ESTRELLA FAMILY MEDICAL, LLC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669593398
- **Authorized official:** MR. BERNARD GOODMAN M.H.A. (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (623) 298-4642

## Contact information

- **Practice address:** 750 N. ESTRELLA PARKWAY, SUITE 20, GOODYEAR, AZ 85338
- **Practice address phone:** (623) 298-4642
- **Practice address fax:** (623) 925-9193
- **Mailing address:** 750 N ESTRELLA PKWY, SUITE 20, GOODYEAR, AZ 85338-9272
- **Mailing address phone:** (623) 298-4642
- **Mailing address fax:** (623) 925-9193

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/02/2007
- **Last updated:** 02/08/2012