MEDICARE: NABOR RIOS MS, PA-C

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
1	363AM0700X	Medical Physician Assistant	2526	AZ

General Provider Information

NPI Number	:	1841269701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NABOR RIOS MS, PA-C

Provider Business Mailing Address
First Line	:	2033 E WARNER RD STE 104
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85284-3417
Country	:	US
Telephone Number	:	480-820-5525
Fax Number	:	480-831-6755

Provider Business Practice Location Address
First Line	:	2033 E WARNER RD STE 109
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85284-3417
Country	:	US
Telephone Number	:	480-820-5525
Fax Number	:	480-831-6755

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	04/18/2018

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