MEDICARE: EDGARDO ZAVALA ALARCON MD

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	207RC0000X	Cardiovascular Disease Physician	27016	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992752232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDGARDO ZAVALA ALARCON MD

Provider Business Mailing Address
First Line	:	PO BOX 63423
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85082-3423
Country	:	US
Telephone Number	:	480-982-2800
Fax Number	:	480-982-1400

Provider Business Practice Location Address
First Line	:	4838 E BASELINE RD
Second Line	:	BLDG. 2 STE. 110
City	:	MESA
State	:	AZ
Zip	:	85206-4671
Country	:	US
Telephone Number	:	480-892-2800
Fax Number	:	480-503-4244

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

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	01/09/2008

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