Provider Demographics
NPI:1538460365
Name:PERSONAL PRIMARY CARE, PLLC
Entity Type:Organization
Organization Name:PERSONAL PRIMARY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:LEFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-298-8127
Mailing Address - Street 1:1200 N EL DORADO PL
Mailing Address - Street 2:SUITE I-900
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-4637
Mailing Address - Country:US
Mailing Address - Phone:520-298-8127
Mailing Address - Fax:520-298-8366
Practice Address - Street 1:1200 N EL DORADO PL
Practice Address - Street 2:SUITE I-900
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-4637
Practice Address - Country:US
Practice Address - Phone:520-298-8127
Practice Address - Fax:520-298-8366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-10
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8350261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
D37177Medicare UPIN
AZZ143517Medicare PIN
AZZ143518Medicare PIN
WDBCR16Medicare PIN