Organization
CENTURY CARE INC
Active
Other names
Atlas Medical Arizona, Atlas Medical
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY CHAD MANGUM (OWNER)
(435) 514-5646
Entity
Organization
Contact information
Practice address
7227 E BASELINE RD STE 126, MESA, AZ 85209-5006
(480) 868-9650
(480) 834-3606
Mailing address
7227 E BASELINE RD STE 126, MESA, AZ 85209-5006
(480) 868-9650
(480) 834-3606
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
12301
AZ
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
09/15/2008
Last updated
11/21/2024
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