Healthcare Provider Details

I. General information

NPI: 1396709762
Provider Name (Legal Business Name): PATRICK ARAMBULA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 06/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 W THOMAS RD 2ND FLOOR
PHOENIX AZ
85013-4240
US

IV. Provider business mailing address

521 W THOMAS RD 2ND FLOOR
PHOENIX AZ
85013-4240
US

V. Phone/Fax

Practice location:
  • Phone: 602-867-1252
  • Fax: 602-867-1256
Mailing address:
  • Phone: 602-867-1252
  • Fax: 602-867-1256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number24203
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: