Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Black Diamond Medical LLC

Organization Family Medicine Physician · NPI 1639644909

Black Diamond Medical LLC is a Family Medicine Physician in Peoria, Arizona. Registered with an NPI since 2018.

In the registry since
2018
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

20449 N Lake Pleasant Rd Ste 101
Peoria, AZ 85382-2707
Phone: (623) 322-0099
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X
Family Medicine Physician Taxonomy 207Q00000X
Urgent Care Clinic/Center Taxonomy 261QU0200X

Record details

NPI number1639644909
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tonia Graham — Co-Owner · (623) 322-0099
NPI enumeratedOctober 12, 2018
Last updated in NPPESMarch 6, 2020
Certification dateMarch 6, 2020
Mailing address20449 N Lake Pleasant Rd Ste 101, Peoria, AZ 85382-2707

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