Provider Demographics
NPI:1457467151
Name:NAVA FAMILY MEDICINE PLLC
Entity Type:Organization
Organization Name:NAVA FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-279-6282
Mailing Address - Street 1:4530 N 32ND ST
Mailing Address - Street 2:STE 104
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3357
Mailing Address - Country:US
Mailing Address - Phone:602-279-6282
Mailing Address - Fax:602-274-2157
Practice Address - Street 1:4530 N 32ND ST
Practice Address - Street 2:STE 104
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3357
Practice Address - Country:US
Practice Address - Phone:602-279-6282
Practice Address - Fax:602-274-2157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24355207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0752990OtherBCBS PIN
AZ2Z0735OtherHEALTHNET PIN
AZ374710Medicaid
AZP00230446OtherRAILROAD MEDICARE
AZG41756Medicare UPIN