Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 008141 | AZ |
NPI | 1003341306 |
---|---|
Provider Name | Dr. Jose Rapanan JR. |
First Address | Phoenix, AZ 85016-2620 |
Second Address | Tucson, AZ 85745-2819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2017 |
Last Update Date | 18/05/2021 |