Organization
ESTRELLA INTERNAL MEDICINE & GERIATRICS CLINIC, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUCIA MAGAT GREGORIO MD (PRESIDENT)
(623) 873-1500
Entity
Organization
Contact information
Practice address
8410 W THOMAS RD, BLDG. 2, SUITE 112, PHOENIX, AZ 85037-3329
(623) 873-1500
(623) 873-4247
Mailing address
8410 W THOMAS RD, BLDG. 2, SUITE 112, PHOENIX, AZ 85037-3329
(623) 873-1500
(623) 873-4247
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
261Q00000X
Clinic/Center
27047
AZ
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z111092
MEDICARE ID - TYPE UNSPECIFIED
AZ
Enumeration date
05/25/2006
Last updated
11/11/2020
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