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General NPI Number Information
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NPI Number | 1497025399
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Entity Type | Organization
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Legal Business Name | CLINICAS DEL DR. CAZARES
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Dates
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Enumeration Date | 01/09/2012
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Last Update Date | 02/21/2012
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Provider Practice Location Address
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Address Line | 6717 N 59TH AVE
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City | GLENDALE
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State | AZ
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Zip | 85301-3205
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Country | US
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Telephone | 623-939-1411
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Fax | 623-939-1465
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Provider Business Mailing Address
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Address Line | 6717 N 59TH AVE
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City | GLENDALE
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State | AZ
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Zip | 85301-3205
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Country | US
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Telephone | 623-939-1411
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Fax | 623-939-1465
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Authorized Official
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Title or Position | GENERALA MANAGER
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Name | TONI A SAMANIEGO
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Credential |
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Telephone | 623-939-1411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 1700
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License Number State | AZ
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