Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 32303 | AZ |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 32303 | AZ |
NPI | 1023011269 |
---|---|
Provider Name | Benigno F Decena III |
First Address | Tucson, AZ 85719-1563 |
Second Address | Tucson, AZ 85712-1256 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 01/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2079115 | FIRST HEALTH (01) | AZ |
2198100 | GHI (01) | AZ |
2Z0331 | HEALTH NET (01) | AZ |
5427615 | CCN (01) | AZ |
7597308 | AETNA (01) | AZ |
830340 | (05) | AZ |
886331 | USA MANAGED CARE ORGANIZA (01) | AZ |
AZ0743710 | BCBS OF ARIZONA (01) | AZ |
H46180 | (02) | AZ |
P00084839 | RAILROAD MEDICARE (01) | AZ |