Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 36739 | AZ |
N | 207RC0200X | Critical Care Medicine | E3687 | AR |
N | 207RP1001X | Pulmonary Disease | 36739 | AZ |
N | 207RP1001X | Pulmonary Disease | E3687 | AR |
NPI | 1003808668 |
---|---|
Provider Name | Dr. Emmanuel A Bayongan |
First Address | Mesa, AZ 85202-4715 |
Second Address | Mesa, AZ 85202-4707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2005 |
Last Update Date | 04/10/2012 |