Organization
BROCA HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IGNACIO CABEZUDO MD (DOCTOR)
(480) 557-5710
Entity
Organization
Contact information
Practice address
1492 S MILL AVE, STE. 114, TEMPE, AZ 85281-5652
(480) 557-5710
(480) 557-5712
Mailing address
3941 E CHANDLER BLVD, STE. 106-158, PHOENIX, AZ 85048-0301
(480) 557-5710
(480) 557-5712
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
29743
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1583670
UNITED HEALTHCARE #
AZ
01
—
2Z2152
HEALTHNET #
AZ
01
—
3267734
AETNA PROVIDER #
AZ
05
—
636293
—
AZ
01
—
7910494
AETNA PIN #
AZ
01
—
825512
AETNA GROUP #
AZ
01
—
9656031
CIGNA #
AZ
01
—
AZ0767110
BCBSAZ #
AZ
Enumeration date
04/24/2007
Last updated
06/02/2010
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