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General NPI Number Information
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NPI Number | 1831476340
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Entity Type | Individual
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Provider Name | ISRAEL CORONADO C.R.N.A.
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Gender | Male
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Dates
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Enumeration Date | 11/11/2011
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 3636 N STOCKTON HILL RD
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City | KINGMAN
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State | AZ
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Zip | 86409-0514
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Country | US
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Telephone | 928-757-3636
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Fax | 928-757-3635
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Provider Business Mailing Address
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Address Line | 1016 S MILE 2 1/2 W
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City | WESLACO
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State | TX
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Zip | 78596-0501
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Country | US
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Telephone | 956-246-7670
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 737234
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 324558
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License Number State | AZ
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