Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | 29264 | AZ |
NPI | 1083680532 |
---|---|
Provider Name | Dr. Rizaldy J Villegas |
First Address | Chandler, AZ 85224-4412 |
Second Address | Chandler, AZ 85224-4412 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2006 |
Last Update Date | 30/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7346669 | AETNA HEALTHCARE (01) | AZ |
971483 | STATE AHCCCS (01) | AZ |
I32429 | (02) | AZ |