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General NPI Number Information
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NPI Number | 1972879773
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Entity Type | Organization
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Legal Business Name | CARELON MEDICAL PARTNERS OF ARIZONA, P.C.
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Dates
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Enumeration Date | 03/26/2012
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 5055 E BROADWAY BLVD SUITE 111
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City | TUCSON
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State | AZ
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Zip | 85711-3640
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Country | US
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Telephone | 520-529-8387
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Fax | 520-844-1111
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Provider Business Mailing Address
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Address Line | 12900 PARK PLAZA DR SUITE 150, MS-6165
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City | CERRITOS
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State | CA
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Zip | 90703-9329
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Country | US
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Telephone | 562-741-4461
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Fax | 562-622-2971
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Authorized Official
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Title or Position | OWNER
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Name | TIMOTHY ALBION
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Credential |
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Telephone | 224-234-5025
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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 | 18791
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License Number State | AZ
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