Basic Information
| Provider Information | |||||||||
| NPI: | 1326247339 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GOOD HEALTH URGENT CARE, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4600 S MILL AVE | ||||||||
| Address2: | SUITE 280 | ||||||||
| City: | TEMPE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852826850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4803052888 | ||||||||
| FaxNumber: | 4803052889 | ||||||||
| Practice Location | |||||||||
| Address1: | 287 E. HUNT HIGHWAY | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | SAN TAN VALLEY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 851435096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4806778282 | ||||||||
| FaxNumber: | 4806778283 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2007 | ||||||||
| LastUpdateDate: | 11/09/2010 | ||||||||
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| AuthorizedOfficialLastName: | ZAMANI | ||||||||
| AuthorizedOfficialFirstName: | PAYAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4806778282 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
ID Information
| ID | Type | State | Issuer | Description | 498938 | 05 | AZ | MEDICAID |