Pebble Creek Medical Group Pllc

NPI #1790213064 in Goodyear, Arizona

Provider Information

NPI Number: 1790213064
Entity Type: Organization
Organization Name: Pebble Creek Medical Group Pllc
Primary Specialty: Internal Medicine
Enumeration Date: May 31, 2017
Last Updated: May 31, 2017

Practice Location

Address: 700 N ESTRELLA PKWY # 130
City: Goodyear
State: Arizona
ZIP Code: 85338-9271
Phone: (623) 322-2144

Authorized Official

Name: SANJAY BOMMAKANTI, MD
Title: MD/OWNER
Phone: (623) 337-6897

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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