Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 51183 | AZ |
Y | 207RC0000X | Internist - Cardiovascular Disease | 51183 | AZ |
NPI | 1568599876 |
---|---|
Provider Name | Carlos Orrego |
First Address | Phoenix, AZ 85069-7337 |
Second Address | Phoenix, AZ 85006-2508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 02/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
071498 | (05) | AZ |