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General NPI Number Information
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NPI Number | 1164387213
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Entity Type | Individual
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Provider Name | VINCENT FABIAN RASCON R.T. (R)(T)(ARRT)
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Gender | Male
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Dates
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Enumeration Date | 12/22/2025
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 1172 W CHIMES TOWER DR
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City | CASA GRANDE
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State | AZ
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Zip | 85122-6868
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Country | US
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Telephone | 928-920-9600
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Fax |
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Provider Business Mailing Address
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Address Line | 4539 N 22ND ST # 5714
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City | PHOENIX
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State | AZ
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Zip | 85016-4639
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Country | US
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Telephone | 928-920-9600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471C3402X
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Taxonomy Name | Radiography Radiologic Technologist
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License Number | CRT-73897
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License Number State | AZ
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