Healthcare Provider Details

I. General information

NPI: 1558665398
Provider Name (Legal Business Name): ARMANDO VALDEZ DE GUZMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2011
Last Update Date: 01/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9420 E GOLF LINKS RD SUITE 108-296
TUCSON AZ
85730-1355
US

IV. Provider business mailing address

9420 E GOLF LINKS RD SUITE 108-296
TUCSON AZ
85730-1355
US

V. Phone/Fax

Practice location:
  • Phone: 520-834-4904
  • Fax: 520-207-0011
Mailing address:
  • Phone: 520-834-4904
  • Fax: 520-207-0011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License Number12665
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number12665
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number12665
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: