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General NPI Number Information
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NPI Number | 1669449104
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Entity Type | Individual
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Provider Name | PAUL G GAITAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/03/2006
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 11030 N. TATUM BLVD BLDG F, SUITE 101
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City | PHOENIX
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State | AZ
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Zip | 85028
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Country | US
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Telephone | 602-889-9880
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Fax | 480-393-7444
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Provider Business Mailing Address
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Address Line | 11030 N. TATUM BLVD BLDG F, SUITE 101
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City | PHOENIX
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State | AZ
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Zip | 85028
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Country | US
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Telephone | 602-889-9880
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Fax | 408-393-7444
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 32717
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License Number State | AZ
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