Provider Demographics
NPI:1255098687
Name:PATHWAYS MEDICAL PARTNERS
Entity type:Organization
Organization Name:PATHWAYS MEDICAL PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BORBON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-325-3978
Mailing Address - Street 1:3978 N CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-1460
Mailing Address - Country:US
Mailing Address - Phone:520-325-3978
Mailing Address - Fax:520-325-3985
Practice Address - Street 1:3978 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-1460
Practice Address - Country:US
Practice Address - Phone:520-325-3978
Practice Address - Fax:520-325-3985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty