Provider Demographics
NPI:1669481172
Name:NEW PIONEER MEDICAL ASSOCIATES INC.
Entity Type:Organization
Organization Name:NEW PIONEER MEDICAL ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VANHELDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-834-4320
Mailing Address - Street 1:1150 N COUNTRY CLUB DR STE 1
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-2537
Mailing Address - Country:US
Mailing Address - Phone:480-834-4320
Mailing Address - Fax:480-834-0009
Practice Address - Street 1:1150 N COUNTRY CLUB DR STE 1
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-2537
Practice Address - Country:US
Practice Address - Phone:480-834-4320
Practice Address - Fax:480-834-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19203207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ133166Medicaid
AZF69595Medicare UPIN
AZZWMBPPMedicare ID - Type Unspecified