Organization
INADVANCE MEDICINE ASSOCIATES WEST, P.C.
Active
Other names
Passport Health
Organization subpart
No
Provider details
NPI number
Authorized official
JUANA SLACK (MEDICAL BILLING SPECIALIST)
(480) 646-9086
Entity
Organization
Contact information
Practice address
11650 IBERIA PLACE, SUITE 110, SAN DIEGO, CA 92128-2406
(877) 358-8648
(877) 877-6875
Mailing address
4343 EAST OUTLIER BLV., SUITE 100W, PHOENIX, AZ 85008-6507
(877) 358-8648
(877) 877-6875
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
08/12/2014
Last updated
12/22/2025
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