Basic Information
| Provider Information | |||||||||
| NPI: | 1477652253 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OASIS FAMILY MEDICINE, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 655 S DOBSON RD STE B113 | ||||||||
| Address2: | |||||||||
| City: | CHANDLER | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852245686 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808550177 | ||||||||
| FaxNumber: | 4808995023 | ||||||||
| Practice Location | |||||||||
| Address1: | 655 S DOBSON RD STE B113 | ||||||||
| Address2: | |||||||||
| City: | CHANDLER | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852245686 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808550177 | ||||||||
| FaxNumber: | 4808995023 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 04/02/2008 | ||||||||
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| AuthorizedOfficialLastName: | BEBAK | ||||||||
| AuthorizedOfficialFirstName: | SANDRA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 4808550177 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 18834 | AZ | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.