Provider Demographics
NPI:1568526366
Name:TRANS4MED PLLC
Entity Type:Organization
Organization Name:TRANS4MED PLLC
Other - Org Name:UCR HEALTH CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEONARAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-855-7585
Mailing Address - Street 1:2745 S ALMA SCHOOL RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-4405
Mailing Address - Country:US
Mailing Address - Phone:480-855-7585
Mailing Address - Fax:480-855-0912
Practice Address - Street 1:2745 S ALMA SCHOOL RD
Practice Address - Street 2:SUITE 2
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-4405
Practice Address - Country:US
Practice Address - Phone:480-855-7585
Practice Address - Fax:480-855-0912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24795261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z109206Medicare PIN