Provider Demographics
NPI:1477652253
Name:OASIS FAMILY MEDICINE, PLLC
Entity Type:Organization
Organization Name:OASIS FAMILY MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEBAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-855-0177
Mailing Address - Street 1:655 S DOBSON RD STE B113
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5686
Mailing Address - Country:US
Mailing Address - Phone:480-855-0177
Mailing Address - Fax:480-899-5023
Practice Address - Street 1:655 S DOBSON RD STE B113
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5686
Practice Address - Country:US
Practice Address - Phone:480-855-0177
Practice Address - Fax:480-899-5023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18834207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ69716Medicare PIN