Dr. Ellen Marie San Buenaventura
Pediatrician Pediatric Emergency Physician
5161 N Stonehouse Pl
Tucson
, Arizona 85750-9671
Dr. Ellen Marie San Buenaventura
Pediatrician Pediatric Emergency Physician
5161 N Stonehouse Pl
Tucson
, Arizona 85750-9671
(520) 749-5889
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About
Features
Specialties
- Pediatric Emergency Physician
- Pediatrician
Languages spoken
- English
Location
First Address
- Dr. Ellen Marie San Buenaventura
- 5161 N Stone House Pl
- Tucson, AZ
- Zip : 85750
- Phone : (520) 749-5889
Second Address
- Dr. Ellen Marie San Buenaventura
- 5161 N Stonehouse Pl
- Tucson, AZ
- Zip : 85750-9671
- Phone : (520) 749-5889
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207PP0204X | Pediatric Emergency Physician | 14454 | AZ |
| N | 208000000X | Pediatrician | 14454 | AZ |
National Provider Identifier
| NPI | 1083796098 |
|---|---|
| Provider Name | Dr. Ellen Marie San Buenaventura |
| First Address | Tucson, AZ 85750 |
| Second Address | Tucson, AZ 85750-9671 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/10/2006 |
| Last Update Date | 07/08/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 240119 | AHCCCS (01) | AZ |
| 240119-10 | (05) | AZ |
| 370016065 | RAILROAD MCR (01) | |
| D00246 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.