Olmedo, Jesse M

Olmedo, Jesse M is an sole proprietor health care provider with primary practice located at 14800 W Mountain View Blvd Suite 160, Surprise AZ 85374-2700. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Olmedo, Jesse M can be contacted via phone (623) 584-3376.

Contact Information

Primary practice address
14800 W Mountain View Blvd Suite 160 Surprise AZ 85374-2700
Phone: (623) 584-3376
Fax: (623) 584-3375
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 30536 Arizona

Profile Details

NPI number 1265490429
LBN Legal business name Olmedo, Jesse M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 3rd, 2006
Last updated Apr 9th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265490429 NPPES
Arizona Other 1265490429 AHCCCS
Arizona Other 2281872 AHCCCS
Arizona Other 99S007000011 AHCCCS
Arizona Other 7538647 AHCCCS
Arizona Other 2Z3349 AHCCCS
Arizona Other AZ0779550 AHCCCS
Arizona Other 188961600 AHCCCS
Arizona Other P00234871 AHCCCS

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