Provider Demographics
NPI:1518188812
Name:SAUNDERS, PATRICIA G (PAC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:G
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 E SAPIUM WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-9553
Mailing Address - Country:US
Mailing Address - Phone:480-628-7821
Mailing Address - Fax:
Practice Address - Street 1:4530 E MUIRWOOD DR STE 110
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-7693
Practice Address - Country:US
Practice Address - Phone:480-763-5808
Practice Address - Fax:480-759-0647
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2689363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZNCCPA CERTIFICATEOther1054902
AZAZ LICENSEOther2689
AZDEAOtherMS0908345