Healthcare Provider Details

I. General information

NPI: 1629030861
Provider Name (Legal Business Name): CARLOS E VARGAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CARLOS E VARGAS MONCALEANO MD

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13400 E SHEA BLVD
SCOTTSDALE AZ
85259-5452
US

IV. Provider business mailing address

13400 E SHEA BLVD
SCOTTSDALE AZ
85259-5452
US

V. Phone/Fax

Practice location:
  • Phone: 480-301-8000
  • Fax:
Mailing address:
  • Phone: 480-301-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberME93663
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number49604
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: