Healthcare Provider Details

I. General information

NPI: 1083303838
Provider Name (Legal Business Name): ALONSO CARRERAS GONZALEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2023
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10401 W THUNDERBIRD BLVD
SUN CITY AZ
85351-3004
US

IV. Provider business mailing address

3100 N.CENTRAL AVE CREIGHTON UNIVERSITY #711D
PHOENIX AZ
85012
US

V. Phone/Fax

Practice location:
  • Phone: 623-832-4728
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number79040
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number79040
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: