=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487610499
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANCISCO JOHN G PERALTA M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/26/2006
-----------------------------------------------------
Last Update Date | 05/14/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10835 NORTH 25TH AVENUE SUITE 115
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85029-3452
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-789-0344
-----------------------------------------------------
Fax | 602-789-8389
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10835 NORTH 25TH AVENUE SUITE 115
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85029-3452
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-789-0344
-----------------------------------------------------
Fax | 602-789-8389
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208M00000X
-----------------------------------------------------
Taxonomy Name | Hospitalist Physician
-----------------------------------------------------
License Number | 29843
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 29843
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------