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General NPI Number Information
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NPI Number | 1528118668
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Entity Type | Organization
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Legal Business Name | DESERT FAMILY PHYSICIANS PC
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 01/22/2013
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Provider Practice Location Address
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Address Line | 5520 E MAIN ST STE 4
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City | MESA
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State | AZ
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Zip | 85205-8793
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Country | US
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Telephone | 480-832-1992
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Fax | 480-830-2402
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Provider Business Mailing Address
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Address Line | 5520 E MAIN ST STE 4
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City | MESA
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State | AZ
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Zip | 85205-8793
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Country | US
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Telephone | 480-832-1992
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Fax | 480-830-2402
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Authorized Official
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Title or Position | PRESIDENT
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Name | CESAR M RODARTE
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Credential | D.O
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Telephone | 480-832-1992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1808
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License Number State | AZ
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