Basic Information
| Provider Information | |||||||||
| NPI: | 1235335852 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADVANCED CARE FOR WOMEN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5323 | ||||||||
| Address2: | |||||||||
| City: | SUN CITY WEST | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853765323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6235840800 | ||||||||
| FaxNumber: | 6239753492 | ||||||||
| Practice Location | |||||||||
| Address1: | 14239 W BELL RD | ||||||||
| Address2: | STE 200 | ||||||||
| City: | SURPRISE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853742469 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6235840800 | ||||||||
| FaxNumber: | 6239753492 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | NEWMAN | ||||||||
| AuthorizedOfficialFirstName: | GARY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6235840800 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 3131 | AZ | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.