Healthcare Provider Details

I. General information

NPI: 1295074458
Provider Name (Legal Business Name): CHRISTIAN PAQUET M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2013
Last Update Date: 02/18/2020
Certification Date: 02/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 N 32ND ST STE 220
PHOENIX AZ
85018-3965
US

IV. Provider business mailing address

1010 E MCDOWELL RD STE LL1
PHOENIX AZ
85006-2606
US

V. Phone/Fax

Practice location:
  • Phone: 602-956-1250
  • Fax:
Mailing address:
  • Phone: 602-956-1250
  • Fax: 602-956-7466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberA124493
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number53661
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: