Healthcare Provider Details

I. General information

NPI: 1881545499
Provider Name (Legal Business Name): NOAH DANIEL VASQUEZ PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 N HIGLEY RD.
GILBERT AZ
85234
US

IV. Provider business mailing address

1900 N HIGLEY RD.
GILBERT AZ
85234
US

V. Phone/Fax

Practice location:
  • Phone: 480-256-6444
  • Fax: 480-256-3682
Mailing address:
  • Phone: 480-256-6444
  • Fax: 480-256-3682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11560
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: