# PUEBLO FAMILY PHYSICIANS LTD

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PUEBLO FAMILY PHYSICIANS LTD
- **Other names:** Pueblo Family Physicians LTD
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1790798072
- **Legal business name:** PUEBLO FAMILY PHYSICIANS LTD
- **Authorized official:** RICK JOHNS (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (602) 850-8913

## Contact information

- **Practice address:** 4350 N 19TH AVE, SUITE 6, PHOENIX, AZ 85015-4602
- **Practice address phone:** (602) 264-9191
- **Practice address fax:** (602) 532-2973
- **Mailing address:** 4350 N 19TH AVE STE 6, PHOENIX, AZ 85015-4602
- **Mailing address phone:** (602) 850-8913
- **Mailing address fax:** (602) 532-2956

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2325 | AZ | Yes |

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 02/09/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 423779 | — | AZ |