1205839388 NPI number — FRANCISCO AMAYA-PINTO M.D.

Table of content: FRANCISCO AMAYA-PINTO M.D. (NPI 1205839388)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205839388 NPI number — FRANCISCO AMAYA-PINTO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AMAYA-PINTO
Provider First Name:
FRANCISCO
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205839388
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10097
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CASA GRANDE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85130-0020
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-836-3446
Provider Business Mailing Address Fax Number:
520-836-8807

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1284 N ARIZONA BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COOLIDGE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85128-3206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-723-9131
Provider Business Practice Location Address Fax Number:
520-723-7974
Provider Enumeration Date:
05/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  26265 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 031814 . This is a "MEDICARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 61788 . This is a "MEDICARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 031813 . This is a "MEDICARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 031828 . This is a "MEDICARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 031815 . This is a "MEDICARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 031820 . This is a "MEDICARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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