Healthcare Provider Details

I. General information

NPI: 1396703013
Provider Name (Legal Business Name): CATHERINE M GIOANNETTI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 05/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7340 E SPEEDWAY BLVD CLARA VISTA PEDIATRICS STE 104
TUCSON AZ
85710-1352
US

IV. Provider business mailing address

5055 E BROADWAY BLVD SUITE A-100
TUCSON AZ
85711-3640
US

V. Phone/Fax

Practice location:
  • Phone: 520-547-7045
  • Fax: 520-547-7060
Mailing address:
  • Phone: 520-327-0460
  • Fax: 520-795-0225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number24498
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: