Provider Demographics
NPI:1003086935
Name:HEALTHFIRST PRIMARY CARE, PLLC
Entity Type:Organization
Organization Name:HEALTHFIRST PRIMARY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR / OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHOBHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARVATHALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-703-4496
Mailing Address - Street 1:2153 E BASELINE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1545
Mailing Address - Country:US
Mailing Address - Phone:480-820-1855
Mailing Address - Fax:480-820-8451
Practice Address - Street 1:2153 E BASELINE RD STE 101
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1545
Practice Address - Country:US
Practice Address - Phone:480-820-1855
Practice Address - Fax:480-820-8451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24647207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z24582Medicare PIN