Provider Demographics
NPI:1407978091
Name:PULMONARY CONSULTANTS P.C.
Entity Type:Organization
Organization Name:PULMONARY CONSULTANTS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY TREASURER PULMONARY CONSU
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:IBARROLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-835-7111
Mailing Address - Street 1:6750 E BAYWOOD AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-1749
Mailing Address - Country:US
Mailing Address - Phone:480-835-7111
Mailing Address - Fax:480-218-5706
Practice Address - Street 1:6750 E BAYWOOD AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1749
Practice Address - Country:US
Practice Address - Phone:480-835-7111
Practice Address - Fax:480-218-5706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZWCHFZMedicare ID - Type UnspecifiedGROUP