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Organization

BANNER PRIMARY CARE PHYSICIANS ARIZONA LLC

Active
Parent organization
BANNER MEDICAL GROUP
Organization subpart
Yes

Provider details

NPI number
Legal business name
BANNER MEDICAL GROUP
Authorized official
SHIVA BIRDI (CEO)
(602) 747-4000
Entity
Organization

Contact information

Practice address
13640 N PLAZA DEL RIO BLVD, STE 102, PEORIA, AZ 85381-4846
(623) 876-3928
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Enumeration date
02/27/2012
Last updated
04/17/2026
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