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General NPI Number Information
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NPI Number | 1245291392
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Entity Type | Organization
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Legal Business Name | AFFILIATED GENERAL SURGEON II PC
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4550 N 51ST AVE SUITE #65
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City | PHOENIX
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State | AZ
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Zip | 85031
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Country | US
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Telephone | 623-846-7608
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Fax | 623-848-9572
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Provider Business Mailing Address
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Address Line | 4550 N 51ST AVE SUITE #65
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City | PHOENIX
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State | AZ
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Zip | 85031
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Country | US
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Telephone | 623-846-7608
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Fax | 623-848-9572
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AGUSTO ANTONIO TORAYA
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Credential | MD
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Telephone | 623-846-7608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 5663
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License Number State | AZ
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