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NPI Code Detail

MEDICARE: DR. AUBREY M PALESTRANT M.D.

MEDICARE:  DR. AUBREY M PALESTRANT  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician13416AZ
22085R0204XVascular & Interventional Radiology Physician13416AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1300124482OTHERAZRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3AZ0221810OTHERBCBSAZ
41Z7086OTHERAZHEALTH NET OF AZ

General Provider Information

NPI Number : 1174595110
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AUBREY M PALESTRANT M.D.
Provider Business Mailing Address
First Line : 10835 N 25TH AVE
Second Line : STE 240
City : PHOENIX
State : AZ
Zip : 85029-3458
Country : US
Telephone Number : 603-294-3920
Fax Number : 602-216-3000
Provider Business Practice Location Address
First Line : 19829 N 27TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85027-4001
Country : US
Telephone Number : 623-879-5720
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2006
Last Update Date : 08/10/2017

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Directions to “ DR. AUBREY M PALESTRANT M.D.” Practice Location

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