Provider Demographics
NPI:1841373701
Name:EAST VALLEY FAMILY HEALTHCARE, PC
Entity type:Organization
Organization Name:EAST VALLEY FAMILY HEALTHCARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:MCFARLANE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-821-9388
Mailing Address - Street 1:3755 S GILBERT RD
Mailing Address - Street 2:STE 109
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297
Mailing Address - Country:US
Mailing Address - Phone:480-821-9388
Mailing Address - Fax:480-821-6326
Practice Address - Street 1:3755 S GILBERT RD
Practice Address - Street 2:STE 109
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297
Practice Address - Country:US
Practice Address - Phone:480-821-9388
Practice Address - Fax:480-821-6326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7029111N00000X
AZ3325R111N00000X
AZ7999111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ113936Medicare UPIN