Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 36383 | AZ |
Y | 111NI0900X | Internist | 36383 | AZ |
N | 207SG0201X | Clinical Genetics (M.D.) | A92992 | CA |
NPI | 1164637187 |
---|---|
Provider Name | Dr. Norman Estrada Mendoza |
First Address | Tucson, AZ 85724-0001 |
Second Address | Tucson, AZ 85724-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2007 |
Last Update Date | 26/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
214805 | (05) | AZ |
ZP03006701 | (02) | AZ |