Healthcare Provider Details

I. General information

NPI: 1205829124
Provider Name (Legal Business Name): CHRISTINA WEISSAUER - CONDON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 05/12/2020
Certification Date: 05/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18857 S LA CANADA DR
SAHUARITA AZ
85629-7990
US

IV. Provider business mailing address

1260 S CAMPBELL AVE BLDG 2
GREEN VALLEY AZ
85614-0503
US

V. Phone/Fax

Practice location:
  • Phone: 520-407-5800
  • Fax: 520-407-5990
Mailing address:
  • Phone: 520-407-5600
  • Fax: 520-407-5990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35252
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: