MEDICARE: ANGELA MARINA PEGARIDO TORRES DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	9322	AZ

General Provider Information

NPI Number	:	1386402840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA MARINA PEGARIDO TORRES DC

Provider Business Mailing Address
First Line	:	1785 W VALENCIA RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85746-6511
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1785 W VALENCIA RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85746-6511
Country	:	US
Telephone Number	:	520-595-3860
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2024
Last Update Date	:	03/11/2024

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