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Organization

ABCORE FAMILY PRACTICE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JUAN J LOPEZ NP (MANAGER)
(623) 419-2799
Entity
Organization

Contact information

Practice address
4141 N HERRERA WAY, PHOENIX, AZ 85012-1814
(623) 419-2799
Mailing address
6223 N 21ST DR, PHOENIX, AZ 85015-1902
(623) 419-2799
(602) 358-7649

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP7356
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
013638
AZ
01
1326477134
NPI
AZ
Enumeration date
02/16/2015
Last updated
12/09/2025
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