# SAN PEDRO FAMILY CARE, PLC

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

## Provider details

- **NPI number:** 1871629733
- **Authorized official:** JANINE F WILEY (MANAGER)
- **Authorized official phone:** (520) 586-3664

## Contact information

- **Practice address:** 890 W 4TH ST, BENSON, AZ 85602-6437
- **Practice address phone:** (520) 586-3664
- **Practice address fax:** (520) 586-3665
- **Mailing address:** 890 W 4TH ST, BENSON, AZ 85602-6437
- **Mailing address phone:** (520) 586-3664
- **Mailing address fax:** (520) 586-3665

## Taxonomy

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

## Other

- **Enumeration date:** 02/26/2007
- **Last updated:** 10/29/2007